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Georgia rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.68 / $93.54 / $523.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.47 / $14.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.36 / $12.33 / $12.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.36 / $11.36 / $22.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $11.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.39 / $19.54 / $53.32
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,221.69 / $2,773.51 / $2,932.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $19.88