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Massachusetts rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $20 · 10th–90th $15$460%20%10th90th$20Professionalmedian $15 · 10th–90th $15$240%50%90th$15$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$15.14 / $24.55 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $37.15 / $50.12
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $29.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $31.62 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $22.39
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $21.88 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $25.12
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $37.15 / $50.12
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $19.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $18.20