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New Jersey 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–$14,4540%10%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.1$0.5$5.0$50.0$500.0$5.0K

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
$0.10 / $0.25 / $2.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.26 / $0.27 / $14.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.13 / $0.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $9,549.93 / $23,988.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $2.75 / $2.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $1.82