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
PROCHLORPERAZINE MALEATE 5 MG ORAL TABLET
Wadena, MN
See all hospitals reporting HCPCS Q0164 →Price type
Astera Health’s median price of $5 is 324% above the median hospital's median price ($1), higher than 84% of the 1,559 hospitals reporting HCPCS Q0164. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield bcbs federal employees [400004] fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Blue Cross Blue Shield bcbs high value network fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Blue Cross Blue Shield blue plus [400058] fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Ucare ucare pmap [300063] percent of total billed charges · outpatientfrom % of charges | $2 | $2 | — | — | — | $2 – $2 |
| 5 | Medica medica mncare [100751] percent of total billed charges · outpatientfrom % of charges | $3 | $3 | — | — | — | $3 – $3 |
| 6 | Medica medica pmap [100345] percent of total billed charges · outpatientfrom % of charges | $3 | $3 | — | — | — | $3 – $3 |
| 7 | Ucare ucare commercial [100748] percent of total billed charges · inpatientfrom % of charges | $4 | $4 | — | — | — | $4 – $4 |
| 8 | Ucare ucare commercial [100748] percent of total billed charges · outpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 9 | UnitedHealthcare united healthcare [100453] percent of total billed charges · inpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 10 | Blue Cross Blue Shield bcbs federal employees [400004] percent of total billed charges · inpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 11 | Blue Cross Blue Shield bcbs high value network percent of total billed charges · inpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 12 | Blue Cross Blue Shield blue plus [400058] percent of total billed charges · inpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 13 | UnitedHealthcare united healthcare [100453] percent of total billed charges · outpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 14 | Medica medica [100341] percent of total billed charges · outpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 15 | MultiPlan multiplan percent of total billed charges · inpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 16 | MultiPlan multiplan percent of total billed charges · outpatientfrom % of charges | $5 | $5 | — | — | — | $5 – $5 |
| 17 | Aetna aetna - fh [100925] percent of total billed charges · inpatientfrom % of charges | $6 | $6 | — | — | — | $6 – $6 |
| 18 | Aetna aetna - fh [100925] percent of total billed charges · outpatientfrom % of charges | $6 | $6 | — | — | — | $6 – $6 |
| 19 | Medica medica [100341] percent of total billed charges · inpatientfrom % of charges | $488 | $488 | — | — | — | $488 – $488 |
| 20 | Ucare ucare pmap [300063] per diem · inpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 21 | Medica medica mncare [100751] per diem · inpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 22 | Medica medica pmap [100345] per diem · inpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
Last updated: Feb 20, 2026
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