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Missouri rates for HCPCS J1572

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

Facilitymedian $85 · 10th–90th $50–$1380%20%10th90th$85Professionalmedian $51 · 10th–90th $48–$630%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
$50.12 / $63.10 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $51.29 / $63.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $56.23 / $281.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $85.11 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $61.66