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New Hampshire rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Facilitymedian $23 · 10th–90th $11–$790%10%10th90th$23Professionalmedian $11 · 10th–90th $9–$170%20%40%10th90th$11$10.0$20.0$50.0$100.0$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
$11.22 / $24.55 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $11.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $19.50 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $11.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $18.62 / $25.70
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
$10.00 / $16.22 / $17.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $70.79