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Tennessee rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $4,266 · 10th–90th $15–$7,7620%20%10th90th$4,266Professionalmedian $15 · 10th–90th $15–$170%50%90th$15$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $4,265.80 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $17.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.85 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $22.91 / $26.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $16.60 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $17.38