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Arizona 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
$1.32 / $4.84 / $70.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.70 / $4.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $2.29 / $3.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.87 / $4.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.59 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.85