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Texas 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 / $1.13 / $13.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $6.00 / $6.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.33 / $5.60
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.13 / $34.13 / $34.13
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.28 / $0.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.59
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.94 / $3.71
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
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04