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Oregon rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $19 · 10th–90th $15–$330%10%20%10th90th$19Professionalmedian $16 · 10th–90th $15–$200%20%40%10th90th$16$20.0$100.0$500.0$2.0K

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
$15.49 / $22.39 / $37.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $21.88 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $16.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $38.02 / $40.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $30.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $16.60 / $22.39
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.85 / $32.36
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $21.88 / $45.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $16.98 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $25.12 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $30.90 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49