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New Hampshire 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
$0.76 / $3.47 / $12.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $1.13 / $3.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.27 / $2.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.81
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.96 / $1.38