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Utah rates for HCPCS J1200

Injection, diphenhydramine HCl, up to 50 mg

Facilitymedian $23 · 10th–90th $5–$680%20%10th90th$23Professionalmedian $2 · 10th–90th $1–$20%20%10th90th$2$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $23.44 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.66 / $2.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $0.93 / $1.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $0.69 / $0.69
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $1.20 / $1.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.79