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Dicyclomine Injection

Washington rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $10$1350%10%20%10th90th$19Professionalmedian $11 · 10th–90th $9$690%20%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
$10.23
Median
$19.50
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$10.23
Typical High
$69.18
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$9.33
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$9.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$25.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$11.48
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$75.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$33.88
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$34.67
Typical High
$34.67
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$17.78
Typical High
$17.78
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$9.33
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$9.33
United
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$26.92
United
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$11.22
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$12.30