HCPCS J0500
Injection, dicyclomine hcl, up to 20 mg
Current code42 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | $131 – $147 | $226 | $226 |
| Capital Medical Center | $77.60 – $184 | $42.52 – $86.42 | $106 – $216 |
| Deaconess Medical Center | $113 – $221 | $121 | $303 |
| EvergreenHealth Medical Center | $24.19 – $148 | $127 | $159 |
| Harborview Medical Center | $23.66 | — | — |
| Highline Medical Center | $113 – $471 | $79.95 – $160 | $262 – $524 |
| Island Hospital | $11.33 | — | — |
| Kadlec Regional Medical Center | $18.50 – $56.62 | $34.61 – $305 | $49.44 – $435 |
| Legacy Salmon Creek Medical Center | $17.89 – $28.94 | — | — |
| MultiCare Auburn Medical Center | $104 – $158 | $57.20 – $86.42 | $143 – $216 |
| MultiCare Covington Medical Center | $104 – $158 | $57.20 – $86.42 | $143 – $216 |
| MultiCare Good Samaritan Hospital | $76.36 – $158 | $41.84 – $86.42 | $105 – $216 |
| MultiCare Valley Hospital | $77.42 – $218 | $83.36 – $121 | $208 – $303 |
| Overlake Hospital Medical Center & Clinics | $27.71 – $29.50 | $8.12 – $38.88 | $16.23 – $77.77 |
| PeaceHealth Peace Island Medical Center | — | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth Southwest Medical Cente | $17.56 | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth St John Medical Center | $19.71 | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth St Joseph Medical Center | $19.61 | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth United General Medical Center | — | $50.13 – $70.85 | $77.13 – $109 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $23.77 – $32.78 | $70.66 – $217 | $101 – $310 |
| Providence Centralia Hospital | $41.30 – $82.48 | $68.68 – $113 | $132 – $217 |
| Providence Holy Family Hospital | $23.77 – $32.78 | $70.66 – $217 | $101 – $310 |
| Providence Regional Medical Center Everett | $23.77 – $32.78 | — | — |
| Providence St Joseph Hospital | — | $697 | $996 |
| Providence St Mary Medical Center | $32.78 – $126 | $37.42 – $574 | $53.46 – $820 |
| Providence St Peter Hospital | $23.77 – $34.09 | $63.60 – $189 | $122 – $363 |
| St Anthony Hospital | $131 – $393 | $79.63 – $159 | $262 – $524 |
| St Clare Hospital | $131 – $393 | $75.47 – $151 | $262 – $524 |
| St Elizabeth Hospital | $20.24 – $471 | $92.52 – $185 | $262 – $524 |
| St Francis Community Hospital | $131 – $393 | $82.16 – $164 | $262 – $524 |
| St Joseph Medical Center | $131 – $393 | $86.71 – $173 | $262 – $524 |
| St Michael Medical Center | $40.66 – $471 | $116 – $231 | $262 – $524 |
| Swedish Edmonds Hospital | $23.35 – $27.98 | — | — |
| Swedish Issaquah | $23.35 – $27.98 | — | — |
| Swedish Medical Center | $23.77 – $27.98 | — | — |
| Swedish Medical Center / Cherry Hill | $23.77 – $27.98 | — | — |
| Tacoma General Allenmore Hospital | $104 – $158 | $57.20 – $86.42 | $143 – $216 |
| Three Rivers Hospital | — | $352 | $352 |
| University of Washington Medical Ctr | $23.66 | — | — |
| Virginia Mason Medical Center | $69.28 | — | — |
| Yakima Valley Memorial | $34.27 – $185 | $86.42 | $216 |
Medicare (traditional) reference
CMS publishes no national amount for this code.