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Maine 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 $0–$10%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$20%50%10th90th$0$0.5$1.0$2.0$5.0$10.0$20.0$50.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.51 / $1.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $1.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.48 / $0.54 / $1.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.48 / $2.04