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Missouri 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
$1.42 / $7.37 / $49.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.91 / $2.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $0.83 / $2.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $6.32 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.90 / $1.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.06