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Utah 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 $3 · 10th–90th $2–$100%20%10th90th$3Professionalmedian $0 · 10th–90th $0–$10%20%40%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
$1.82 / $2.75 / $9.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.71 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.25 / $0.33 / $44.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.07
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.04 / $0.04
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.16 / $0.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02