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Texas rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $31 · 10th–90th $15$830%10%10th90th$31Professionalmedian $15 · 10th–90th $15$250%50%90th$15$10.0$50.0$200.0$1.0K$5.0K

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
$15.14 / $30.90 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $25.12
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $38.02 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $36.31 / $102.33
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 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $2,089.30
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $26.92
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $47.86
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