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Ohio 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–$30%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%20%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0

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
$0.20 / $1.26 / $2.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $5.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.14 / $0.28 / $0.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.05 / $0.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.21 / $1.82 / $2.45
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.82 / $4.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.33 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.16
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $85.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.17 / $0.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.34 / $4.17 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13