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Ohio 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
$1.09 / $3.53 / $16.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.17 / $3.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.13 / $1.78 / $4.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.28
Aultcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.90 / $1.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.90 / $1.03
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 / $1.98
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $3.55 / $21.55
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.76 / $1.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.95 / $1.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $0.94