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Massachusetts 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–$260%20%40%10th90th$1Professionalmedian $0 · 10th–90th $0–$20%50%10th90th$0$0.2$2.0$20.0$200.0$2.0K$20.0K$200.0K

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
$1.12 / $16.98 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.51 / $1.66
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.55 / $5.13 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $218.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $0.52 / $1.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.62 / $1.00 / $2.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.44 / $83.18 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.27 / $0.93 / $1.45
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.55 / $5.13 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.47 / $1.07 / $1.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.48 / $2.04