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Connecticut rates for HCPCS J1572

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

Facilitymedian $85 · 10th–90th $58–$1510%10%10th90th$85Professionalmedian $54 · 10th–90th $44–$560%50%10th90th$54$50.0$100.0

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
$53.70 / $85.11 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $53.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $125.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $56.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $60.26 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $58.88