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Mississippi rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $4,266 · 10th–90th $15–$7,0790%10%20%10th90th$4,266Professionalmedian $15 · 10th–90th $15–$190%50%90th$15$20.0$100.0$500.0$2.0K$10.0K

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
$15.85 / $4,265.80 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $18.20 / $21.88
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 / $16.60 / $16.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $23.99