Price of Dicyclomine 10 mg/ml Injection at NYU Langone
Last Updated: 2024-07-01
Locations
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NYU Langone|Tisch Hospital
550 1st Ave., New York, NY 10016About Dicyclomine 10 mg/ml Injection
Service Codes: HCPCS J0500, LOCAL 5010003
This procedure involves administering Dicyclomine as an intramuscular injection to help relieve muscle spasms in the gastrointestinal tract, often used for conditions like irritable bowel syndrome.
Pricing Overview
Cash Price
$69.49
Median Price
$106.06
Price Range
$36.57 - $266.98
Insurance Plan Prices
| Insurance Provider | Plan Type | Price |
|---|---|---|
| EmblemHealth | HIP VIP Medicare Affinity | $106.06 |
| EmblemHealth | GHI EPO | $146.29 |
| EmblemHealth | Select Care Healthcare Partners | $106.06 |
| EmblemHealth | HIP Optum Health | $106.06 |
| EmblemHealth | GHI Behavioral Management Program | $146.29 |
| EmblemHealth | GHI Medicare Supplement | $146.29 |
| EmblemHealth | GHI Medicare PPO | $146.29 |
| EmblemHealth | HIP Montefiore | $106.06 |
| MagnaCare | Capital District Physicians Health Plan | $87.77 |
| MultiPlan | Screen Actors Guild | $266.98 |
| MultiPlan | Meritain Health | $266.98 |
| EmblemHealth | Select Care Gold Exchange | $106.06 |
| Cigna | Premier Plus | $117.03 |
| EmblemHealth | HIP EPO | $106.06 |
| MetroPlus | MedPlus | $113.37 |
| MagnaCare | National Health Plan | $87.77 |
| MagnaCare | Direct Plus Preferred | $87.77 |
| EmblemHealth | HIP VIP Medicare Healthcare Partners | $106.06 |
| UnitedHealthcare | POMCO (UMR) | $266.98 |
| Cigna | Indemnity | $117.03 |
| Aetna | Open Access HMO | $109.72 |
| EmblemHealth | HIP HMO | $106.06 |
| MultiPlan | PPO | $266.98 |
| MetroPlus | Essential Plan 1 | $69.49 |
| Cigna | LifeSOURCE | $117.03 |
| EmblemHealth | Select Care Platinum Small Group | $106.06 |
| Aetna | Wellnet ASA PPO | $109.72 |
| UnitedHealthcare | Golden Rule Insurance | $36.57 |
| EmblemHealth | Select Care Catastrophic Exchangeu00a0 | $106.06 |
| EmblemHealth | CMO Essential Plan 1 | $106.06 |
| EmblemHealth | HIP compre health | $106.06 |
| MultiPlan | Kaiser Permanente | $266.98 |
| EmblemHealth | Prime Silver | $106.06 |
| Cigna | Open Access PPO | $117.03 |
| MultiPlan | Diversified Admin Corp | $266.98 |
| Cigna | Cigna Managed Care/POS | $117.03 |
| EmblemHealth | Healthcare Partners Essential Plan 3-4 | $106.06 |
| UnitedHealthcare | Independent | $36.57 |
| EmblemHealth | Enhanced Care (Medicaid) | $106.06 |
| MultiPlan | US Life Insurance Co | $266.98 |
| EmblemHealth | Select Care Silver Exchange | $106.06 |
| UnitedHealthcare | PPO | $36.57 |
| Cigna | MVP-Cigna Network | $117.03 |
| MagnaCare | Cement & Concrete Workers District Council | $87.77 |
| GEHA | All Plans | $109.72 |
| EmblemHealth | GHI Comprehensive Benefits Plan (CBP) | $146.29 |
| MetroPlus | Essential Plan 3 | $47.54 |
| Aetna | Chesterfield Resources ASA PPO | $109.72 |
| Aetna | PPO | $109.72 |
| UnitedHealthcare | Optum Health | $36.57 |
| MultiPlan | Healthnet of California | $266.98 |
| UnitedHealthcare | Student Resources | $36.57 |
| MultiPlan | PHCS | $266.98 |
| Cigna | Tufts Health Plan | $117.03 |
| MagnaCare | PPO | $87.77 |
| MagnaCare | American Plan Administrators | $87.77 |
| EmblemHealth | CMO Essential Plan 2 | $106.06 |
| MultiPlan | Teamsters Allied Benefits | $266.98 |
| UnitedHealthcare | Core | $36.57 |
| EmblemHealth | Select Care Basic Exchange | $106.06 |
| MultiPlan | Humana Health Plan | $266.98 |
| UnitedHealthcare | Choice (NY Power Authority) | $36.57 |
| MultiPlan | Principal Financial Group | $266.98 |
| MultiPlan | QualCare Inc | $266.98 |
| Aetna | Nippon Life ASA PPO | $109.72 |
| MetroPlus | SilverPlus | $113.37 |
| UnitedHealthcare | Navigate | $36.57 |
| Aetna | Healthscope ASA PPO | $109.72 |
| EmblemHealth | Healthcare Partners Essential Plan 1-2 | $106.06 |
| Cigna | Evernorth Behavioral Health | $117.03 |
| EmblemHealth | HIP compre health epo | $106.06 |
| MultiPlan | Paramount Insurance | $266.98 |
| EmblemHealth | GHI PPO | $146.29 |
| UnitedHealthcare | Charter | $36.57 |
| MultiPlan | Guardian Life Insurance Co | $266.98 |
| EmblemHealth | GHI HMO | $146.29 |
| EmblemHealth | HIP Access II | $106.06 |
| First Health | PPO | $266.98 |
| EmblemHealth | GHI composite | $146.29 |
| EmblemHealth | CMO Essential Plan 3 | $106.06 |
| Humana | All Commercial Plans | $266.98 |
| EmblemHealth | Bridge | $106.06 |
| Aetna | HMO | $109.72 |
| Aetna | Open Access Elect Choice EPO | $109.72 |
| UnitedHealthcare | POMCO (UMR) | $36.57 |
| EmblemHealth | HIP POS | $106.06 |
| MultiPlan | Global Excel Management | $266.98 |
| Cigna | HMO | $117.03 |
| EmblemHealth | HIP VIP Medicare Montefiore | $106.06 |
| EmblemHealth | Healthcare Partners Essential Plan 1, 200-250 | $106.06 |
| EmblemHealth | American Plan Administrators c/o H.D.A | $146.29 |
| Aetna | Meritain Health | $109.72 |
| Aetna | Christian Brothers ASA PPO | $109.72 |
| EmblemHealth | IUOE Local 14-14B | $146.29 |
| EmblemHealth | Essential Plan 3 | $106.06 |
| EmblemHealth | American Plan Administrators | $146.29 |
| UnitedHealthcare | Choice (North Shore - LIJ) | $36.57 |
| MetroPlus | BronzePlus | $113.37 |
| Maksin Group | Consolidated Health Plan (Home-based only) | $117.03 |
| EmblemHealth | HIP VIP Medicare Reserve | $106.06 |
| EmblemHealth | HIP VIP Medicare Bold | $106.06 |
| MultiPlan | Mutual of Omaha | $266.98 |
| MetroPlus | GoldCare 2 | $73.14 |
| Cigna | PPO | $117.03 |
| EmblemHealth | VIP Prime HMO Medicare Advantage | $106.06 |
| EmblemHealth | CMO Essential Plan 4 | $106.06 |
| EmblemHealth | HIP Long Island College Hospital (LICH) | $106.06 |
| MultiPlan | PHCS Director Guild | $266.98 |
| EmblemHealth | HIP Healthcare Partners HMO | $106.06 |
| UnitedHealthcare | EPO | $36.57 |
| EmblemHealth | HIP PPO | $106.06 |
| MultiPlan | Fiserv Health | $266.98 |
| EmblemHealth | Select Care Bronze Small Group | $106.06 |
| EmblemHealth | Enhanced Care (Medicaid) Montefiore | $106.06 |
| EmblemHealth | Enhanced Care (Medicaid) Healthcare Partners | $106.06 |
| EmblemHealth | Essential Plan 2 | $106.06 |
| MultiPlan | Nippon Life | $266.98 |
| EmblemHealth | Healthcare Partners Essential Plans | $106.06 |
| MagnaCare | JIB Employees Security Fund | $87.77 |
| MultiPlan | PHCS Savility | $266.98 |
| Aetna | Student Health | $109.72 |
| MultiPlan | Global Health Management | $266.98 |
| EmblemHealth | HIP Medicare Supplement | $106.06 |
| UnitedHealthcare | HMO | $36.57 |
| EmblemHealth | Select Care Silver Small Group | $106.06 |
| EmblemHealth | Healthcare Partners Essential Plan 2 | $106.06 |
| Cigna | NALC PPO | $117.03 |
| EmblemHealth | Healthcare Partners Essential Plan 3 | $106.06 |
| Cigna | Open Access | $117.03 |
| EmblemHealth | HIP SmartStart | $106.06 |
| EmblemHealth | Prime Bronze | $106.06 |
| MultiPlan | PHP Healthcare (Champus) | $266.98 |
| Aetna | Global National Transplant | $109.72 |
| MetroPlus | Gold | $73.14 |
| EmblemHealth | Vytra HMO | $106.06 |
| EmblemHealth | Select Care HMO | $106.06 |
| Aetna | Allied ASA PPO | $109.72 |
| MultiPlan | Administrative Concepts | $266.98 |
| Cigna | Great West HMO | $117.03 |
| EmblemHealth | Select Care PPOu00a0 | $106.06 |
| Cigna | Wellfleet Student | $117.03 |
| MagnaCare | JIB Members | $87.77 |
| EmblemHealth | HIP | $106.06 |
| UnitedHealthcare - Oxford | Optum Health | $36.57 |
| MetroPlus | Medicaid Managed Care | $47.54 |
| Aetna | Indemnity | $109.72 |
| EmblemHealth | Essential Plan 1, 200-250 | $106.06 |
| UnitedHealthcare - Oxford | Liberty | $36.57 |
| Aetna | Starmark ASA PPO | $109.72 |
| Cigna | Great West PPO | $117.03 |
| Cigna | Open Access HMO | $117.03 |
| EmblemHealth | Select Care EPO | $106.06 |
| EmblemHealth | Select Care Bronze Exchange | $106.06 |
| MultiPlan | AXA Global Insurance | $266.98 |
| EmblemHealth | WLNY-TV | $146.29 |
| EmblemHealth | Prime Gold | $106.06 |
| EmblemHealth | GHI Medicare HMO | $146.29 |
| MultiPlan | Capital District Physicians Health Plan | $266.98 |
| Aetna | Signature Administrators PPO | $109.72 |
| EmblemHealth | HIP Child Health Plus | $106.06 |
| MetroPlus | Essential Plan 4 | $47.54 |
| EmblemHealth | Healthcare Partners Essential Plan 4 | $106.06 |
| Aetna | Coresource ASA PPO | $109.72 |
| UnitedHealthcare - Oxford | Freedom | $36.57 |
| EmblemHealth | Select Care Gold Small Group | $106.06 |
| UnitedHealthcare | POS | $36.57 |
| MetroPlus | PlatinumPlus | $113.37 |
| EmblemHealth | Essential Plan 4 | $106.06 |
| MetroPlus | Child Health Plus (CHP) | $47.54 |
| EmblemHealth | Select Care Platinum Exchange | $106.06 |
| Health Net | PPO | $266.98 |
| MetroPlus | GoldPlus | $113.37 |
| EmblemHealth | HIP Prime Basic | $106.06 |
| MetroPlus | Essential Plan 3-4 | $47.54 |
| MetroPlus | Essential Plan 1-2, 200-250 | $69.49 |
| EmblemHealth | HIP Access I | $106.06 |
| Aetna | POS | $109.72 |
| MagnaCare | Direct Plus | $87.77 |
| EmblemHealth | Prime Platinum | $106.06 |
| UnitedHealthcare - Oxford | Metro | $36.57 |
| UnitedHealthcare | Choice | $36.57 |
| MagnaCare | Independent Care Plus | $87.77 |
| MetroPlus | Essential Plan 2 | $69.49 |