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New Mexico 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 $1 · 10th–90th $0–$100%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%50%10th$0$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$5.37 / $6.61 / $9.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.11 / $0.15 / $1.91
Providence
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
$0.13 / $1.95 / $2.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13