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 TABLET
Peoria, IL
See all hospitals reporting HCPCS Q0164 →Price type
Proctor Community Hospital’s median price of $2 is 85% above the median hospital's median price ($1), higher than 66% of the 1,564 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: 7 payers, 19 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 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Aetna Better Health managed medicaid percent of total billed charges · inpatientfrom % of charges | $1 | $47 | $128 | 274% | — | $1 – $410 |
| 4 | Aetna Better Health managed medicaid percent of total billed charges · outpatientfrom % of charges | $1 | $47 | $128 | 274% | — | $1 – $410 |
| 5 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $2 | $56 | $154 | 274% | — | $1 – $492 |
| 6 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $2 | $56 | $154 | 274% | — | $1 – $492 |
| 7 | Molina medicare-medicaid (mmai/dual) percent of total billed charges · inpatientfrom % of charges | $2 | $56 | $154 | 274% | — | $1 – $492 |
| 8 | Molina medicare-medicaid (mmai/dual) percent of total billed charges · outpatientfrom % of charges | $2 | $56 | $154 | 274% | — | $1 – $492 |
| 9 | Blue Cross Blue Shield blue choice percent of total billed charges · outpatientfrom % of charges | $2 | $73 | $200 | 274% | — | $1 – $640 |
| 10 | Blue Cross Blue Shield blue choice options percent of total billed charges · outpatientfrom % of charges | $2 | $73 | $200 | 274% | — | $1 – $640 |
| 11 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $2 | $74 | $203 | 274% | — | $1 – $648 |
| 12 | UnitedHealthcare ppo percent of total billed charges · inpatientfrom % of charges | $2 | $75 | $206 | 274% | — | $1 – $659 |
| 13 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $2 | $75 | $206 | 274% | 9–90 | $1 – $659 |
| 14 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $3 | $90 | $248 | 274% | — | $1 – $790 |
| 15 | Aetna commercial ppo percent of total billed charges · outpatientfrom % of charges | $3 | $92 | $252 | 274% | — | $1 – $804 |
| 16 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $3 | $94 | $257 | 274% | — | $1 – $820 |
| 17 | MultiPlan ppo percent of total billed charges · inpatientfrom % of charges | $3 | $94 | $257 | 274% | — | $1 – $820 |
| 18 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $3 | $94 | $257 | 274% | — | $1 – $820 |
| 19 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $4 | $125 | $344 | 274% | — | $2 – $1.1k |
Last updated: Apr 15, 2026
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