Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HYDROXYZINE PAMOATE 25 MG ORAL CAP [3777]
Low
$0
Average
$137.3k
Median
$4
High
$6542.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
52 payers; the 90th percentile is 189755.4× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +24 other terms | 394 | $3 | $83 | $1.1k | 1313% | 80–107 | $0 – $21.1k |
| 2 | Kaiser fee schedule · both · +11 other terms | 44 | $3 | $477 | $2.2k | 463% | 46 | $2 – $10.8k |
| 3 | Bcbs Wy other · both · +1 other terms | 1 | $6 | $6 | — | — | 31 | $6 – $6 |
| 4 | Cigna fee schedule · outpatient · +17 other terms | 192 | $0 | $2 | $18 | 786% | — | $0 – $438 |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +23 other terms | 186 | $0 | $0 | $1 | 206% | — | $0 – $7 |
| 6 | Aetna fee schedule · outpatient · +23 other terms | 130 | $0 | $3 | $7 | 244% | — | $0 – $35 |
| 7 | Humana fee schedule · outpatient · +16 other terms | 88 | $1 | $5 | $20 | 428% | — | $0 – $273 |
| 8 | Anthem fee schedule · outpatient · +16 other terms | 50 | $0 | $1 | $3 | 293% | — | $0 – $32 |
| 9 | Bcbs Tx fee schedule · outpatient · +1 other terms | 30 | $0 | $0 | $0 | 31% | — | $0 – $0 |
| 10 | Excellus facility · fee schedule · both · +2 other terms | 29 | $0 | $0 | $0 | 92% | — | $0 – $1 |
| 11 | Regence facility · fee schedule · both · +10 other terms | 29 | $0 | $0 | $0 | 111% | — | $0 – $3 |
| 12 | Carefirst facility · fee schedule · both · +4 other terms | 28 | $0 | $0 | $0 | 92% | — | $0 – $1 |
| 13 | Highmark facility · fee schedule · both · +11 other terms | 28 | $0 | $0 | $0 | 92% | — | $0 – $1 |
| 14 | Premera facility · fee schedule · both · +7 other terms | 28 | $0 | $0 | $0 | 92% | — | $0 – $1 |
| 15 | Wellmark facility · fee schedule · both · +6 other terms | 28 | $0 | $0 | $0 | 92% | — | $0 – $1 |
| 16 | MultiPlan fee schedule · inpatient · +13 other terms | 19 | $9 | $13 | $16 | 124% | — | $0 – $77 |
| 17 | Medica fee schedule · outpatient · +12 other terms | 16 | $0 | $1 | $3 | 201% | — | $0 – $9 |
| 18 | Caresource facility · case rate · outpatient · +8 other terms | 15 | $9 | $10 | $2 | 23% | — | $6 – $15 |
| 19 | Molina facility · case rate · outpatient · +19 other terms | 15 | $9 | $10 | $2 | 23% | — | $6 – $15 |
| 20 | Bcbs Mn fee schedule · outpatient · +5 other terms | 12 | $0 | $0 | $0 | 121% | — | $0 – $1 |
| 21 | Bcbs Nj fee schedule · outpatient | 12 | $0 | $0 | $0 | 27% | — | $0 – $0 |
| 22 | Optum facility · case rate · outpatient · +7 other terms | 11 | $8 | $9 | $2 | 22% | — | $7 – $13 |
| 23 | Ambetter fee schedule · both · +7 other terms | 9 | $0 | $3 | $4 | 144% | — | $0 – $11 |
| 24 | Oscar percent of total billed charges · outpatientfrom % of charges · +3 other terms | 9 | $4 | $2 | $2 | 90% | — | $0 – $5 |
| 25 | Ucare fee schedule · both · +3 other terms | 9 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS Q0177 · Snapshot 20261111T120946Z-9134e7f7