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Wisconsin 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 $0 · 10th–90th $0–$70%10%10th90th$0Professionalmedian $0 · 10th–90th $0–$20%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
$0.04 / $0.08 / $8.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.50 / $1.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.93
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.30 / $0.42
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.31 / $0.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.40 / $0.65
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.33
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.28 / $8.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $33.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.25 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.38 / $0.40
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.71 / $1.15
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $85.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $33.88
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.38 / $0.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $3.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $79.43