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Rhode Island rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.92 / $70.40 / $117.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.68 / $11.68 / $35.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $11.36 / $11.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.80 / $11.36 / $11.36