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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

Facilitymedian $0 · 10th–90th $0–$10%50%90th$0Professionalmedian $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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $3.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $0.56 / $1.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $218.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.10 / $1.51
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.15 / $1.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.04 / $2.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.66
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.47
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.47