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North Dakota rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $15 · 10th–90th $15$280%50%10th90th$15Professionalmedian $15 · 10th–90th $14$190%20%10th90th$15$10.0$20.0

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 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.60
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $16.22 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $19.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $15.14 / $26.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $16.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $15.49 / $19.50