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Nebraska rates for HCPCS Q0177

Hydroxyzine Pamoate 25mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.28 / $7.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $2.91 / $5.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.16 / $0.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $61.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.43 / $2.91 / $4.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $3.27 / $5.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.13 / $0.15