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Texas 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–$30%10%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%10th$0$0.0$0.5$10.0$200.0$5.0K$100.0K$2.0M

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
$0.56 / $1.41 / $10.23
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
$0.07 / $0.07 / $0.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.07
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.20 / $0.20 / $0.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.31 / $0.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $1.86
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.11 / $3.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $64.57
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $0.63
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $3.24 / $3.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.10 / $0.16