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Hydroxyzine Pamoate, Oral

Illinois 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

Rates data updated July 2026.

How much does Hydroxyzine Pamoate, Oral cost?

$0.13

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $0.13 for this service. The price depends on where it is billed: about $0.12 from a physician practice, and about $0.26 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.12$0.12 to $0.13
FacilityA hospital or hospital-owned outpatient department$0.26$0.20 to $1.17

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $4Professionalmedian $0 · 10th to 90th $0 to $2
$0.1$1.0$10.0$100.0$1.0Kfacility $0professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.12
Median
$0.26
Typical High
$3.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.12
Median
$0.12
Typical High
$0.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.81
Median
$1.41
Typical High
$6.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.18
Median
$0.24
Typical High
$0.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.15
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$0.62
Median
$2.57
Typical High
$3.31
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$0.07
Median
$2,511.89
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$2.45
Median
$3.31
Typical High
$3.31
United
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.14

Where Illinois sits

The same service costs 4.4 times more in West Virginia than in Texas. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $0.13 · 21st of 51
WV $0.52TX $0.12

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.