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South Dakota 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 $2 · 10th–90th $0–$70%20%10th90th$2Professionalmedian $0 · 10th–90th $0–$00%20%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0

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
$0.95 / $1.86 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.05 / $0.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $33.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $0.48 / $0.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02