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New Hampshire 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–$20%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$10%50%10th90th$0$0.2$1.0$5.0$20.0

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
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.51 / $1.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.98 / $1.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.54 / $0.95 / $1.32
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 / $0.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.48 / $1.55
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.62 / $0.89 / $1.23