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West Virginia rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $11,482 · 10th–90th $15–$19,9530%20%40%10th90th$11,482Professionalmedian $15 · 10th–90th $15–$170%50%10th90th$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 / $11,481.54 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $17.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $20.42