go back

Virginia rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.42 / $43.51 / $183.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.93 / $11.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.81 / $31.65 / $47.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $11.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.66 / $13.63 / $54.87
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.36 / $11.36 / $103.47
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.79 / $13.75 / $39.90
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.79 / $13.75 / $39.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.18 / $11.36 / $14.26