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Iowa rates for HCPCS Q0175

Perphenazine 4 Mg Oral Fda Approved Prescription Anti-Emetic For Use As A Complete Therapeutic Substitute For An Iv Anti- Emetic At The Time Of Chemotherapy Treatment Not To Exceed A 48 Hour Dosage Regimen (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $1.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.46 / $0.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.75 / $1.23
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $1.94 / $1.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.59 / $2.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $218.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $1.00 / $1.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $1.10 / $1.53
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.48
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.47 / $0.47