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Pennsylvania rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Facilitymedian $50 · 10th–90th $13$1410%10%10th90th$50Professionalmedian $11 · 10th–90th $11$630%50%90th$11$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$16.98 / $52.48 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $63.10
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $17.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $12.30 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $11.75
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $33.11 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $16.22 / $16.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $28.84 / $138.04
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $17.38
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $125.89
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $12.02
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,905.46 / $2,398.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $23.99 / $34.67
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $23.99 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $20.89