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Alaska rates for HCPCS J1240

Injection, dimenhydrinate, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.98 / $14.26 / $50.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.82 / $11.42 / $18.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $6.14
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.32 / $16.32 / $16.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $19.77
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.09 / $19.38 / $30.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.75 / $19.38 / $45.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $6.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $9.21 / $12.39