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Hawaii rates for HCPCS J1240

Injection, dimenhydrinate, up to 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.73 / $16.73 / $16.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.73 / $16.73 / $16.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $6.14 / $6.14
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.66 / $12.66 / $14.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.75 / $7.37 / $8.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $9.21 / $10.41
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $8.32 / $10.83