J0875 — Dalbavancin 500 Mg Intravenous Solution
$3,441
All-payer median here
$4,025
Cash / self-pay here
20
payer/plan-name variants
Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.