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Montana 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

Facilitymedian $1 · 10th–90th $0–$60%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$10%50%10th90th$0$0.0$0.5$10.0$200.0$5.0K$100.0K$2.0M

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.24 / $3.31 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.55 / $0.68
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $0.62 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.52
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.56 / $0.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.56 / $0.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.07 / $0.62
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02