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Georgia 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 / $12.74 / $56.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.83 / $1.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.82 / $1.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $0.76 / $0.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $1.32 / $1.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $0.97