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Michigan 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–$30%50%10th90th$1Professionalmedian $0 · 10th–90th $0–$30%20%10th90th$0$0.1$0.5$2.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.58 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.51 / $3.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $2.14 / $6.61
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $2.75 / $3.47
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.47 / $0.56 / $1.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.68