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Illinois 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
$1.33 / $14.25 / $57.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.12 / $2.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.48 / $4.68 / $21.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.09 / $1.09
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.13 / $9.88
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.99 / $0.99 / $0.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.02