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Hydroxyzine Pamoate, Oral

Utah 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 July 2026.

How much does Hydroxyzine Pamoate, Oral cost?

$0.13

Typical physician fee. In Utah, July 2026.

Insurers have agreed to pay about $0.13 for this service. Most negotiated rates run $0.12 to $0.13.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $16Professionalmedian $0 · 10th to 90th $0 to $0
$0.1$0.2$0.5$1$2$5$10facility $1professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.12
Median
$0.56
Typical High
$15.85
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.12
Median
$0.12
Typical High
$0.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$0.49
Median
$0.49
Typical High
$0.65
Select Health
Setting
Facility
Modifier
Global
Typical Low
$0.27
Median
$0.27
Typical High
$0.27
Select Health
Setting
Professional
Modifier
Global
Typical Low
$0.27
Median
$0.27
Typical High
$0.27
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$0.79
Median
$1.02
Typical High
$1.07
United
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.13

Where Utah sits

The same service costs 4.4 times more in West Virginia than in Texas. 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.

Utah· 5th of 51

$0.13

WV $0.52TX $0.12

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.