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California rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $20 · 10th–90th $16$420%20%40%10th90th$20Professionalmedian $16 · 10th–90th $15$380%20%40%10th90th$16$10.0$50.0$200.0$1.0K$5.0K

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
$23.99 / $33.11 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $38.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $18.20 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $16.22 / $44.67
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $19.05 / $30.90
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $19.95 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $25.70 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $16.98 / $35.48
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $22.91 / $37.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $28.84
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $27.54
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $16.60 / $25.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $51.29 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $38.02