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New Jersey 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
$1.07 / $3.08 / $10.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $3.63 / $67.09
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $1.37 / $1.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.94 / $0.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.97