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Washington, DC rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $46 · 10th–90th $15–$590%20%10th90th$46Professionalmedian $15 · 10th–90th $15–$160%50%90th$15$20.0$50.0

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
$15.14 / $48.98 / $58.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.85
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $23.99 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $30.90 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $25.12