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Vermont rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $11.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $12.88 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $11.22 / $11.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $11.22 / $43.65