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Oregon rates for HCPCS J1572

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

Facilitymedian $60 · 10th–90th $52–$1820%20%10th90th$60Professionalmedian $52 · 10th–90th $43–$630%50%10th90th$52$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
$52.48 / $53.70 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $117.49 / $229.09
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $181.97
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $60.26 / $104.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $53.70 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $53.70 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $186.21 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48