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Massachusetts 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
$0.98 / $3.07 / $7.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.79 / $1.97
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $2.33 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $0.97 / $2.06
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $83.43 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.61
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.88 / $1.43 / $9.89
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.67
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.86 / $1.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.67