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Oregon 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 $0 · 10th–90th $0–$10%20%40%10th90th$0Professionalmedian $0 · 10th–90th $0–$40%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
$0.36 / $0.48 / $0.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.20 / $0.20 / $0.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $4.37 / $5.62
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $0.74
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.06 / $0.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $0.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $79.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.49 / $0.49 / $0.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13