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Montana rates for HCPCS J1200

Injection, diphenhydramine HCl, up to 50 mg

Facilitymedian $10 · 10th–90th $1–$740%5%10%10th90th$10Professionalmedian $2 · 10th–90th $1–$30%10%10th90th$2$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $21.38 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.62 / $2.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.69 / $2.14 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $2.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $0.69 / $0.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.87 / $0.89 / $2.45
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.89 / $2.45
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $2.14
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71