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Tennessee rates for HCPCS J1572

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

Facilitymedian $79 · 10th–90th $52–$4570%10%20%10th90th$79Professionalmedian $52 · 10th–90th $51–$550%50%10th90th$52$50.0$100.0$200.0$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
$52.48 / $52.48 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $52.48 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $58.88