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Nebraska 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–$80%10%10th90th$0Professionalmedian $0 · 10th–90th $0–$40%20%40%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

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
$0.65 / $7.08 / $18.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $0.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.04 / $0.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.40 / $4.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.08 / $0.16 / $1.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $61.66
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $3.24 / $5.01
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $3.55 / $4.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $2.34 / $5.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.14