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Connecticut rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $29 · 10th–90th $17–$4,5710%10%10th90th$29Professionalmedian $15 · 10th–90th $15–$170%50%90th$15$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
$17.38 / $38.02 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $16.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $23.44 / $38.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $18.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $15.49 / $19.05