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Iowa rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $15 · 10th–90th $15–$200%50%90th$15Professionalmedian $16 · 10th–90th $15–$260%20%40%10th90th$16$0.0$0.2$2.0$20.0$200.0$2.0K

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 / $19.95 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $26.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $17.78 / $19.95
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $28.18 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $17.78 / $29.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $26.92
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $20.42 / $20.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $16.22
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49