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Ohio rates for HCPCS J1572

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

Facilitymedian $91 · 10th–90th $51$2290%10%10th90th$91Professionalmedian $54 · 10th–90th $50$660%50%10th90th$54$1.0$5.0$20.0$100.0$500.0

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 / $51.29 / $194.98
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
$57.54 / $120.23 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $63.10 / $97.72
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $85.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $81.28
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $58.88