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Wyoming rates for HCPCS J0875

Injection, dalbavancin, 5 mg

Facilitymedian $31 · 10th–90th $15$560%20%10th90th$31Professionalmedian $21 · 10th–90th $15$210%50%10th$21$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.49 / $15.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $20.89 / $20.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.38 / $21.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $30.90 / $33.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49