go back

California 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–$40%50%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%10th90th$0$0.1$1.0$20.0$500.0$10.0K$200.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$0.38 / $11.22 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.14 / $0.15 / $0.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.22
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.14 / $0.17
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.16 / $0.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.26 / $0.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $398.11 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.04
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $2.75
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $7.41 / $7.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.13 / $0.16