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New Mexico rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $38 · 10th–90th $17–$1150%10%20%10th90th$38Professionalmedian $15 · 10th–90th $15–$230%50%10th90th$15$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$16.98 / $23.99 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $77.62 / $123.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $20.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.45
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $30.20
Providence
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 / $15.49 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49