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Tennessee 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
$1.11 / $5.04 / $50.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.68 / $1.68
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.67