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Alaska rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $17 · 10th–90th $15–$15,4880%20%40%10th90th$17Professionalmedian $15 · 10th–90th $15–$290%50%90th$15$20.0$100.0$500.0$2.0K$10.0K

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
$102.33 / $15,488.17 / $15,488.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $33.88
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $47.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $23.44 / $46.77
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $41.69
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $16.98 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $31.62