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Dalbavancin Injection

New Hampshire rates for HCPCS J0875 · Dalvance

Injection, dalbavancin, 5 mg

Rates data updated July 2026.

How much does Dalbavancin Injection cost?

$2,770per dose

One 915 mg dose, at the doctor's office rate. In New Hampshire, July 2026.

Negotiated ratewhat insurers pay per 5 mg of the drug
$15.14 / 5 mg
Average doseacross Medicare claims, discarded units included
× 915 mg
One dosedrug only; giving it and the visit are billed separately
$2,770

Work out the cost of a dose

This drug is priced per 5 mg. Enter the amount given to see what insurers have agreed to pay for it. Prefilled with the average administration in Medicare claims, discarded units included.

mg
In a doctor's office or clinic
$2,770
At a hospital outpatient department
$4,492

The same drug, in the same amount, costs 62% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where the price changes

Given atPer 5 mgPer 915 mg dose
Doctor's office or clinic$15.14$2,770
Hospital outpatient department$24.55$4,492

How much rates vary

Facilitymedian $25 · 10th to 90th $15 to $59Professionalmedian $15 · 10th to 90th $15 to $28
$20$50facility $25professional $15

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$17.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$16.98
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$39.81
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$16.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$29.51
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$25.12
Typical High
$28.84
United
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.49
Typical High
$22.91

Where New Hampshire sits

The same service costs 2.5 times more in West Virginia than in Louisiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 41st of 51

$15.49

WV $37.15LA $15.14

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.