go back

Utah rates for HCPCS J1200

Injection, diphenhydramine HCl, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.36 / $21.34 / $59.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $1.52 / $2.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.86 / $0.97 / $1.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.76 / $0.85