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Colorado 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
$0.02 / $1.26 / $7.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $329.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02