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Maine rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Facilitymedian $28 · 10th–90th $26$5250%20%10th90th$28Professionalmedian $11 · 10th–90th $9$160%20%40%10th90th$11$2.0$10.0$50.0$200.0

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
$26.30 / $28.18 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $19.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $26.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.55 / $11.22
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $10.96 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $11.22 / $63.10