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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

Facilitymedian $1 · 10th–90th $0–$10%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$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
$2.09 / $2.09 / $2.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $0.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.51 / $0.81 / $1.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.11 / $0.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $3.24 / $3.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13