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Alaska rates for HCPCS Q0163

Diphenhydramine HCl, 50 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at time of chemotherapy treatment not to exceed a 48-hour dosage regimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.90 / $7.24 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.36 / $9.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $60.26 / $60.26
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.04
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05