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South Dakota rates for HCPCS J1572

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

Facilitymedian $52 · 10th–90th $52–$630%50%90th$52Professionalmedian $54 · 10th–90th $52–$660%50%10th90th$54$50.0$100.0

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
$42.66 / $63.10 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $53.70 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $66.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $72.44 / $154.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $58.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $58.88
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48