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Virginia rates for HCPCS J1572

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

Facilitymedian $95 · 10th–90th $54–$2400%10%20%10th90th$95Professionalmedian $54 · 10th–90th $50–$540%50%10th$54$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
$53.70 / $53.70 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $53.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $52.48 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $107.15 / $134.90
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
$63.10 / $63.10 / $63.10
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
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 / $63.10