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Hydroxyzine Pamoate, Oral

Oklahoma 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

Rates data updated October 2026.

How much does Hydroxyzine Pamoate, Oral cost?

$0.13

Typical negotiated rate. In Oklahoma, October 2026.

Insurers have agreed to pay about $0.13 for this service. The price depends on where it is billed: about $0.13 from a physician practice, and about $0.83 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.13$0.11 to $0.13
FacilityA hospital or hospital-owned outpatient department$0.83$0.59 to $1.12

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $62
$0.1$0.5$2$10$50facility $1professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.11
Median
$0.12
Typical High
$0.12
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.12
Median
$0.12
Typical High
$0.12
BCBS Oklahoma
Setting
Facility
Modifier
None
Typical Low
$0.56
Median
$0.91
Typical High
$1.45
Cigna
Setting
Facility
Modifier
None
Typical Low
$0.20
Median
$0.20
Typical High
$0.20
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.13
Median
$0.13
Typical High
$0.13
Medica
Setting
Facility
Modifier
None
Typical Low
$0.10
Median
$0.11
Typical High
$0.12
Medica
Setting
Professional
Modifier
None
Typical Low
$0.10
Median
$0.12
Typical High
$61.66
United
Setting
Professional
Modifier
None
Typical Low
$0.11
Median
$0.13
Typical High
$0.13
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.06
Median
$0.06
Typical High
$0.06
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.02
Median
$0.02
Typical High
$0.02

Where Oklahoma sits

The same service costs 32.4 times more in Montana than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Oklahoma· 39th of 51

$0.13

MT $2.88HI $0.09

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.