go back

Iowa 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
$1.36 / $14.74 / $136.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.70 / $4.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.79 / $0.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.05 / $2.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.95 / $23.08 / $59.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.95 / $1.39
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $1.00 / $1.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.93 / $1.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.78 / $0.90
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.90