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Indiana 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–$10%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0–$20%20%40%10th90th$1$0.2$1.0$5.0$20.0

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 / $1.12 / $2.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.58 / $1.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.65 / $0.71 / $1.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.55 / $0.85
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $0.72 / $1.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.60 / $1.32 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $1.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.60