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Indiana 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
$2.29 / $8.52 / $55.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $2.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $1.52 / $2.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.64 / $0.76 / $1.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.87
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 / $2.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.29