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Delaware rates for HCPCS J0875

Injection, Dalbavancin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.60 / $40.11 / $27,266.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.61 / $36.25 / $2,970.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.61 / $15.61 / $15.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.61 / $17.07 / $23.42