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Utah rates for HCPCS J1569

Injection, immune globulin, (Gammagard liquid), nonlyophilized, (e.g., liquid), 500 mg

Facilitymedian $4,074 · 10th–90th $54–$21,3800%10%10th90th$4,074Professionalmedian $54 · 10th–90th $47–$1050%20%40%10th90th$54$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
$102.33 / $4,073.80 / $27,542.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $53.70 / $8,511.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $91.20
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $53.70 / $53.70
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $48.98 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $52.48