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Dicyclomine Injection

Wisconsin rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Rates data updated July 2026.

Facilitymedian $28 · 10th–90th $10$1290%5%10%10th90th$28Professionalmedian $10 · 10th–90th $9$280%50%10th90th$10$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
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$57.54
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.55
Typical High
$50.12
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$12.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$27.54
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$16.98
Typical High
$20.89
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$64.57
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$22.91
Typical High
$22.91
Medica
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$117.49
Medica
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$22.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$64.57
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$69.18
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$64.57
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$22.91
Typical High
$22.91
Quartz
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$14.45
Typical High
$39.81
Quartz
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$28.84
Typical High
$100.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$30.20
Security Health
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$26.30
United
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$15.85