go back

Dicyclomine Injection

Utah rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Rates data updated July 2026.

Facilitymedian $85 · 10th–90th $11$3090%10%10th90th$85Professionalmedian $11 · 10th–90th $9$110%50%10th90th$11$10.0$20.0$50.0$100.0$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$85.11
Typical High
$309.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$17.38
Typical High
$30.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$9.33
Select Health
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$9.33
Typical High
$13.49
United
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$11.22