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New Jersey rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $31 · 10th–90th $19–$12,5890%20%10th90th$31Professionalmedian $15 · 10th–90th $15–$230%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
$19.95 / $29.51 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $18.20 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $20.89
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $9,549.93 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $19.05 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $17.78