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Dalbavancin Injection

Utah rates for HCPCS J0875 · Dalvance

Injection, dalbavancin, 5 mg

Rates data updated July 2026.

How much does Dalbavancin Injection cost?

$3,180per dose

One 915 mg dose, at the doctor's office rate. In Utah, July 2026.

Negotiated ratewhat insurers pay per 5 mg of the drug
$17.38 / 5 mg
Average doseacross Medicare claims, discarded units included
× 915 mg
One dosedrug only; giving it and the visit are billed separately
$3,180

Work out the cost of a dose

This drug is priced per 5 mg. Enter the amount given to see what insurers have agreed to pay for it. Prefilled with the average administration in Medicare claims, discarded units included.

mg
In a doctor's office or clinic
$3,180
At a hospital outpatient department
$3,180

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where the price changes

Given atPer 5 mgPer 915 mg dose
Doctor's office or clinic$17.38$3,180
Hospital outpatient department$17.38$3,180

How much rates vary

Facilitymedian $17 · 10th to 90th $17 to $40Professionalmedian $17 · 10th to 90th $15 to $17
$20$50facility $17professional $17

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$22.39
Typical High
$37.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$32.36
Typical High
$45.71
Select Health
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$16.22
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$15.14
Typical High
$18.62
United
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$15.49

Where Utah sits

The same service costs 2.5 times more in West Virginia than in Louisiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 14th of 51

$17.38

WV $37.15LA $15.14

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.