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Illinois rates for HCPCS Q0175

Perphenazine, 4 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48-hour dosage regimen

Facilitymedian $1 · 10th–90th $1–$110%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$20%50%10th90th$0$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.05 / $1.15 / $1.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.51 / $1.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $4.68 / $22.39
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.89 / $1.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.56
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $1.95 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.24 / $2,511.89 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.07 / $1.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $2.04