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Hydroxyzine Pamoate, Oral

North Carolina 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 North Carolina, July 2026.

Insurers have agreed to pay about $0.13 for this service. The price depends on where it is billed: about $0.13 from a physician practice, and about $0.13 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$0.13$0.12 to $0.14
FacilityA hospital or hospital-owned outpatient department$0.13$0.09 to $0.19

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $0
$0.1$1.0$10.0$100.0facility $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
$0.08
Median
$0.13
Typical High
$3.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.12
Typical High
$0.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.14
Median
$0.14
Typical High
$0.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.15
Median
$0.20
Typical High
$0.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$6.46
Medcost
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$0.13
Typical High
$0.46
United
Setting
Facility
Modifier
Global
Typical Low
$2.45
Median
$3.31
Typical High
$3.72
United
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.13
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66

Where North Carolina 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.

North Carolina $0.13 · 26th 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.