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Perphenazine, Oral

South Dakota 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

Rates data updated July 2026.

Facilitymedian $1 · 10th–90th $0$10%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0$20%20%10th90th$1$0.5$2.0$10.0$50.0$200.0

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
Setting
Facility
Modifier
Global
Typical Low
$0.45
Median
$0.56
Typical High
$0.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.45
Median
$0.56
Typical High
$0.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.76
Typical High
$0.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.50
Median
$0.56
Typical High
$1.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.47
Typical High
$218.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.98
Median
$1.10
Typical High
$1.51
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.15
Typical High
$1.15
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$2.04
Typical High
$2.04
United
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.47
Typical High
$0.62
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$0.47
Median
$0.47
Typical High
$0.47
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.47
Typical High
$0.47