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Alaska rates for HCPCS J1200

Injection Diphenhydramine Hcl Up To 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.75 / $20.48 / $76.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.40 / $2.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $20.56 / $127.40
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $2.45
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $2.35 / $3.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $2.69 / $6.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.13 / $2.27