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Virginia 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 / $0.13 / $30.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
CareFirst
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.42 / $1.34
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.36
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.79 / $1.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.08
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02