Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION
Low
$4
Average
$97
Median
$46
High
$439
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
73 hospitals; the 90th percentile is 16.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
83 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Fleming County Hospital Flemingsburg, KY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $377 | $377 | — | — | 1–10 | $377 – $377 |
| 2 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $4 | $4 | — | — | 1–10 | $4 – $4 |
| 3 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $184 | $184 | — | — | — | $184 – $184 |
| 4 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 5 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 6 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $26 | $32 | $10 | 30% | — | $26 – $48 |
| 7 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $23 | $37 | $27 | 73% | — | $18 – $90 |
| 8 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $36 | $26 | 73% | — | $17 – $87 |
| 9 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $36 | $26 | 73% | — | $17 – $87 |
| 10 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $45 | $33 | 73% | — | $22 – $111 |
| 11 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 12 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $375 | $375 | — | — | — | $375 – $375 |
| 13 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $39 | $51 | $22 | 43% | — | $24 – $81 |
| 14 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $48 | $21 | 43% | — | $22 – $76 |
| 15 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 16 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 17 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 18 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 19 | Hemet Global Medical Center Hemet, CA professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 20 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $36 | $72 | $44 | 61% | — | $35 – $130 |
| 21 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $99 | $189 | $184 | 97% | — | $80 – $555 |
| 22 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · inpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 23 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 24 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · inpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 25 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
← Payers reporting HCPCS J0500 · Snapshot 20261111T120946Z-9134e7f7