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Virginia rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $29 · 10th–90th $15–$9,7720%10%20%10th90th$29Professionalmedian $15 · 10th–90th $15–$190%50%10th90th$15$0.2$2.0$20.0$200.0$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 / $33.11 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $16.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $30.20 / $51.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $25.12
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $23.99 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $28.18 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.49 / $20.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $26.92
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $17.78 / $21.88
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $17.78 / $21.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $19.50