HCPCS J0500
Injection, dicyclomine hcl, up to 20 mg
Current code42 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | — | $226 | $226 |
| Capital Medical Center | — | $42.52 – $86.42 | $106 – $216 |
| Deaconess Medical Center | — | $121 | $303 |
| EvergreenHealth Medical Center | — | $127 | $159 |
| Harborview Medical Center | — | — | — |
| Highline Medical Center | — | $79.95 – $160 | $262 – $524 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $34.61 – $305 | $49.44 – $435 |
| Legacy Salmon Creek Medical Center | — | — | — |
| MultiCare Auburn Medical Center | — | $57.20 – $86.42 | $143 – $216 |
| MultiCare Covington Medical Center | — | $57.20 – $86.42 | $143 – $216 |
| MultiCare Good Samaritan Hospital | — | $41.84 – $86.42 | $105 – $216 |
| MultiCare Valley Hospital | — | $83.36 – $121 | $208 – $303 |
| Overlake Hospital Medical Center & Clinics | — | $8.12 – $38.88 | $16.23 – $77.77 |
| PeaceHealth Peace Island Medical Center | — | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth Southwest Medical Cente | — | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth St John Medical Center | — | $50.13 – $70.85 | $77.13 – $109 |
| PeaceHealth St Joseph Medical Center | — | $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. | — | $70.66 – $217 | $101 – $310 |
| Providence Centralia Hospital | — | $68.68 – $113 | $132 – $217 |
| Providence Holy Family Hospital | — | $70.66 – $217 | $101 – $310 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $697 | $996 |
| Providence St Mary Medical Center | — | $37.42 – $574 | $53.46 – $820 |
| Providence St Peter Hospital | — | $63.60 – $189 | $122 – $363 |
| St Anthony Hospital | — | $79.63 – $159 | $262 – $524 |
| St Clare Hospital | — | $75.47 – $151 | $262 – $524 |
| St Elizabeth Hospital | — | $92.52 – $185 | $262 – $524 |
| St Francis Community Hospital | — | $82.16 – $164 | $262 – $524 |
| St Joseph Medical Center | — | $86.71 – $173 | $262 – $524 |
| St Michael Medical Center | — | $116 – $231 | $262 – $524 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | — | $57.20 – $86.42 | $143 – $216 |
| Three Rivers Hospital | $246 | $352 | $352 |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | — | — |
| Yakima Valley Memorial | — | $86.42 | $216 |
Medicare (traditional) reference
CMS publishes no national amount for this code.