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Immune Globulin (Flebogamma/Flebogamma Dif) Injection

Montana rates for HCPCS J1572

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

Rates data updated July 2026.

How much does Immune Globulin (Flebogamma/Flebogamma Dif) Injection cost?

$60.26per 500 mg

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $60.26 for each 500 mg of this drug. The price depends on where it is billed: about $52.48 from a physician practice, and about $64.57 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per 500 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$52.48
At a hospital outpatient department
$64.57

The same drug, in the same amount, costs 23% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$52.48$52.48 to $66.07
FacilityA hospital or hospital-owned outpatient department$64.57$60.26 to $66.07

How much rates vary

Facilitymedian $65 · 10th to 90th $41 to $66Professionalmedian $52 · 10th to 90th $45 to $66
$50$100facility $65professional $52

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$60.26
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$60.26
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$64.57
Typical High
$66.07
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$64.57
Typical High
$66.07
Providence
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$60.26
Typical High
$75.86
Providence
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$60.26
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48

Where Montana sits

The same service costs 1.7 times more in Alaska than in Iowa. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 12th of 51

$60.26

AK $85.11IA $51.29

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.