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Indiana rates for HCPCS J1572

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

Facilitymedian $79 · 10th–90th $51–$1480%20%10th90th$79Professionalmedian $51 · 10th–90th $50–$680%50%10th90th$51$50.0$100.0$200.0

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
$51.29 / $51.29 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $50.12 / $63.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $79.43 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $85.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $57.54 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $147.91 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $112.20 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $58.88 / $104.71