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New Mexico 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
$2.00 / $15.96 / $48.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.96 / $1.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.36 / $1.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.79 / $1.48
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76