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Maryland 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
$1.47 / $4.38 / $9.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.28
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.12
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73