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West 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 $1 · 10th–90th $1–$20%10%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$20%50%90th$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
$0.55 / $1.26 / $2.29
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.21 / $1.74 / $2.57
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.78 / $4.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.68
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.46 / $0.98 / $1.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.31 / $3.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.13 / $0.15