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Minnesota rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $31 · 10th–90th $15–$520%20%10th90th$31Professionalmedian $15 · 10th–90th $13–$170%50%10th90th$15$0.0$0.1$0.5$2.0$10.0$50.0

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 / $15.14 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $30.90 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $15.49 / $15.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $18.62 / $20.42
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $60.26
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $21.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $22.91 / $33.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $20.89
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 / $28.84