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Louisiana 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 $2 · 10th–90th $0–$50%20%40%10th90th$2Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.1$0.1$0.2$0.5$1.0$2.0$5.0

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
$2.69 / $3.80 / $6.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $4.79
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.28 / $0.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.28 / $0.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $1.95 / $2.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13