Injection of dalbavancin, 5 mg at AMH Cath Labs LLC

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

DALBAVANCIN 500 MG INTRAVENOUS SOLN [125669]

Arlington, TX

See all hospitals reporting HCPCS J0875 →

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Pricing by billing methodology

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How this price compares nationally

AMH Cath Labs LLC’s median price of $2.2k is 7223% above the median hospital's median price ($30), higher than 76% of the 1,897 hospitals reporting HCPCS J0875. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0875 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield medicare advantage case rate · outpatient	$16	$16	—	—	—	$16 – $16
2	Humana medicare advantage case rate · outpatient	$16	$16	—	—	—	$16 – $16
3	Humana medicare advantage ppo case rate · outpatient	$16	$16	—	—	—	$16 – $16
4	Molina medicare advantage case rate · outpatient	$16	$16	—	—	—	$16 – $16
5	WellCare medicare advantage hmo case rate · outpatient	$16	$16	—	—	—	$16 – $16
6	WellCare medicare advantage mmp case rate · outpatient	$17	$17	—	—	—	$17 – $17
7	UnitedHealthcare medicare advantage ppo case rate · outpatient	$17	$17	—	—	—	$17 – $17
8	UnitedHealthcare medicare advantage hmo case rate · outpatient	$18	$18	—	—	—	$18 – $18
9	Blue Cross Blue Shield hmo fee schedule · outpatient	$31	$31	—	—	—	$31 – $31
10	Blue Cross Blue Shield exchange fee schedule · outpatient	$32	$32	—	—	—	$32 – $32
11	Blue Cross Blue Shield ppo fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
12	UnitedHealthcare all payer fee schedule · outpatient	$57	$57	—	—	—	$57 – $57
13	UnitedHealthcare ppo fee schedule · outpatient	$57	$57	—	—	—	$57 – $57
14	Blue Cross Blue Shield traditional fee schedule · outpatient	$143	$143	—	—	—	$143 – $143
15	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$523	$523	—	—	—	$523 – $523
16	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$523	$523	—	—	—	$523 – $523
17	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$549	$549	—	—	—	$549 – $549
18	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$564	$564	—	—	—	$564 – $564
19	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$575	$575	—	—	—	$575 – $575
20	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
21	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$2.4k	$2.4k	—	—	—	$2.4k – $2.4k
22	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$2.7k	$2.7k	—	—	—	$2.7k – $2.7k
23	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$3.2k	$3.2k	—	—	—	$3.2k – $3.2k
24	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$3.2k	$3.2k	—	—	—	$3.2k – $3.2k
25	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$4.1k	$4.1k	—	—	—	$4.1k – $4.1k

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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