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New Mexico 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 / $2.25 / $4.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.31 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.28 / $0.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02