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Wisconsin rates for HCPCS J0500

Injection, dicyclomine HCl, up to 20 mg

Facilitymedian $52 · 10th–90th $12$1290%5%10%10th90th$52Professionalmedian $11 · 10th–90th $9$270%20%10th90th$11$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $54.95 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $23.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $11.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $33.11 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $14.45 / $20.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $64.57
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $22.91 / $22.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $117.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $22.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $69.18
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $14.45 / $67.61
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $87.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $15.85