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Georgia rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $5,888 · 10th–90th $15–$25,1190%10%20%10th90th$5,888Professionalmedian $15 · 10th–90th $15–$180%50%90th$15$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$15.49 / $8,317.64 / $26,915.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $20.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $54.95 / $81.28
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 / $27.54 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $38.90 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $30.20 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $20.89