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.
Original text from hospital filings
INJECTION, DALBAVANCIN, 5 MG
Willits, CA
See all hospitals reporting HCPCS J0875 →Price type
Willits Hospital Inc’s median price of $4.2k is 13756% above the median hospital's median price ($30), higher than 90% of the 1,897 hospitals reporting HCPCS J0875. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 13 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 | Medicaid medi-cal fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 2 | UnitedHealthcare uhc all payer - all other plans fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 3 | UnitedHealthcare uhc jll fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 4 | Blue Cross Blue Shield blue cross non mcs fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
| 5 | Blue Cross Blue Shield blue cross mcs - all other plans fee schedule · outpatient | $102 | $102 | — | — | — | $102 – $102 |
| 6 | Blue Cross Blue Shield blue shield mcare percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 7 | Blue Cross Blue Shield tricare blue shield - all plans percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 8 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 9 | Blue Cross Blue Shield blue shield epn percent of total billed charges · outpatientfrom % of charges | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 10 | Blue Cross Blue Shield blue shield - all other plans percent of total billed charges · outpatientfrom % of charges | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 11 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 12 | First Health first health ppo - all plans percent of total billed charges · outpatientfrom % of charges | $6.5k | $6.5k | — | — | — | $6.5k – $6.5k |
| 13 | Cigna cigna - all plans percent of total billed charges · outpatientfrom % of charges | $6.9k | $6.9k | — | — | — | $6.9k – $6.9k |
Last updated: May 20, 2026
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