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West Virginia rates for HCPCS Q0177

Hydroxyzine Pamoate 25mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $1.23 / $2.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $1.73 / $2.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $2.21 / $4.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.51 / $0.73 / $1.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.15