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South Carolina rates for HCPCS J1572

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

Facilitymedian $68 · 10th–90th $47–$1320%10%20%10th90th$68Professionalmedian $52 · 10th–90th $44–$550%50%10th90th$52$20.0$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 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $53.70
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $75.86 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $63.10 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $79.43 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $60.26