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North Carolina 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 / $0.06 / $12.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.27 / $42.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.27
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.41
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $4.63 / $4.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.13 / $34.13 / $34.13