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West Virginia 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 / $2.59 / $10.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $2.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.90 / $1.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $1.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.76 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $5.04 / $14.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.97