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Georgia 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 / $8.60 / $26.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $70.00 / $83.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $1.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.30 / $0.45
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $2.13
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $4.00 / $5.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03