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Delaware rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.14 / $145.75 / $366.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $27.23 / $29.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.38 / $144.38 / $380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $17.04 / $53.77