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Immune Globulin (Flebogamma/Flebogamma Dif) Injection

New Hampshire 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?

$53.70per 500 mg

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $53.70 for each 500 mg of this drug. The price depends on where it is billed: about $53.70 from a physician practice, and about $77.62 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
$53.70
At a hospital outpatient department
$77.62

The same drug, in the same amount, costs 45% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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$53.70$52.48 to $53.70
FacilityA hospital or hospital-owned outpatient department$77.62$63.10 to $95.50

How much rates vary

Facilitymedian $78 · 10th to 90th $60 to $126Professionalmedian $54 · 10th to 90th $52 to $54
$50$100$200facility $78professional $54

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
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$60.26
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$125.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$107.15
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$58.88
Typical High
$58.88
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$52.48
Typical High
$58.88

Where New Hampshire 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.

New Hampshire· 33rd of 51

$53.70

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.