go back

Arizona rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $33 · 10th–90th $15–$910%10%10th90th$33Professionalmedian $16 · 10th–90th $15–$260%20%40%10th90th$16$10.0$50.0$200.0$1.0K

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
$22.39 / $28.84 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $26.30
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $57.54 / $104.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $29.51 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $24.55 / $29.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $20.42 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $21.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49