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Florida rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.04 / $150.62 / $324.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $12.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $11.36 / $11.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.36 / $11.36 / $15.71
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $12.00 / $12.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $19.88
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.68 / $11.68