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New York 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–$8,1280%10%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$50%50%90th$0$0.1$1.0$20.0$500.0$10.0K$200.0K

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
$0.15 / $1.10 / $38,904.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $0.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.23 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.45
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.25
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.25 / $0.25
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.41
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.22 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $0.52 / $0.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $2.09 / $2.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $1.32 / $50.12
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.25
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.25 / $0.25