go back

North Dakota rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.36 / $20.44 / $50.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.32 / $12.38 / $12.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $12.36 / $12.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.09 / $13.09 / $16.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.50 / $25.44 / $51.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.68 / $11.68 / $13.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.66 / $11.36 / $14.90