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Alaska rates for HCPCS J1572

Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg

Facilitymedian $91 · 10th–90th $89–$1410%20%40%10th90th$91Professionalmedian $54 · 10th–90th $44–$1000%50%10th90th$54$50.0$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $123.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $85.11
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $91.20 / $141.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $53.70 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $812.83