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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $16.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.48 / $0.53
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.60 / $5.70 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.52 / $218.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.65 / $1.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.94 / $1.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.36 / $20.36 / $20.36
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $218.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.59