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Louisiana rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $17 · 10th–90th $15–$350%50%10th90th$17Professionalmedian $15 · 10th–90th $15–$170%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 / $16.22 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $16.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $17.38
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $29.51 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $16.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $17.38