go back

Utah 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

Professionalmedian $0 · 10th–90th $0–$20%20%40%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.26 / $1.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.24 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $2.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.62 / $2.14
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.34 / $0.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.47 / $0.47