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South Dakota rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Facilitymedian $93 · 10th–90th $11–$3160%10%20%10th90th$93Professionalmedian $11 · 10th–90th $11–$140%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
$10.96 / $141.25 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $12.02
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $13.18 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $14.45
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $19.95 / $97.72
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $11.75 / $12.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $19.50
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.48