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Alaska rates for HCPCS Q0177

Hydroxyzine pamoate, 25 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–$30%10%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.17 / $2.75
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.82 / $60.26
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.17 / $0.17 / $0.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.14 / $0.14
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.17 / $2.75
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $2.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.33