go back

Ohio 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
$0.43 / $2.24 / $13.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.50 / $1.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $17.78 / $36.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.28 / $0.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.30 / $0.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.30 / $0.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.78 / $85.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02