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Kansas 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%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%10th$0$0.1$0.2$1.0$5.0$20.0

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
$0.51 / $0.85 / $5.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.31 / $0.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.08 / $0.11 / $0.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13