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Pharmacy Supply Fee, First Prescription in 30 Days

Pennsylvania rates for HCPCS Q0511

Pharmacy supply fee for oral anticancer, oral antiemetic, or immunosuppressive drug(s); for the first prescription in a 30-day period

Rates data updated July 2026.

How much does Pharmacy Supply Fee, First Prescription in 30 Days cost?

$13.80

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $13.80 for this service. The price depends on where it is billed: about $13.80 from a physician practice, and about $0.02 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$13.80$10.96 to $19.95
FacilityA hospital or hospital-owned outpatient department$0.02$0.02 to $5,012

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $57,544Professionalmedian $14 · 10th to 90th $2 to $28
$0.1$1$10$100$1K$10K$100Kfacility $0professional $14

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.58
Median
$9.55
Typical High
$10.96
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$16.22
Typical High
$16.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$34.67
Typical High
$77.62
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$0.11
Median
$2.69
Typical High
$10.96
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$44.67
Typical High
$53.70
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$23.99
Typical High
$39.81

Where Pennsylvania sits

The same service costs 63.1 times more in North Carolina than in Nebraska. 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.

Pennsylvania· 17th of 51

$13.80

NC $100NE $1.58

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.