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Kentucky 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $0.65 / $0.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.55 / $0.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.68 / $0.91
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.63 / $0.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.48 / $0.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.50