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South Carolina 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
$4.53 / $29.32 / $79.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.80 / $3.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $6.66 / $22.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.76 / $1.43
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 / $0.76
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $0.87 / $2.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $0.85