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Kentucky 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–$00%50%90th$0$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$0.15 / $0.51 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $1.78 / $2.69
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.78 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.17 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13