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Minnesota 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
$0.95 / $2.14 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.11 / $0.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.06 / $0.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $1.26 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.40 / $0.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $1.20 / $1.41
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.28 / $2.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04