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Iowa 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–$20%50%90th$0Professionalmedian $0 · 10th–90th $0–$30%20%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

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
Facility
Modifier
Typical Low / Median / Typical High
$0.19 / $1.62 / $5.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.38 / $2.51
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $2.19 / $3.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $3.24
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $61.66
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $2.88 / $4.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $4.07 / $5.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $3.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.14
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13