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Virginia 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 $2 · 10th–90th $0–$70%10%10th90th$2Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

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
$1.78 / $3.02 / $8.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $0.20
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.23 / $0.33
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
$1.95 / $2.34 / $3.98
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $6.46 / $6.46
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.15 / $0.56
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.13 / $0.13
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.54 / $0.54 / $0.54
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.54 / $0.54 / $0.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $3.24 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.13