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Tennessee rates for HCPCS Q0177

Hydroxyzine Pamoate 25mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $0.15 / $23.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.12 / $0.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.16 / $61.16 / $61.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.13 / $0.13