Vivaglobin immune globulin injection, 100 mg

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Vivaglobin, inj

Payers reporting HCPCS J1562

Payer pricing summary

Low

Average

$169

Median

$46

High

$856

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +8 other terms	196	$13	$23	$66	287%	—	$5 – $682
2	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	115	$29	$33	$26	81%	—	$0 – $187
3	Aetna fee schedule · outpatient · +8 other terms	95	$18	$33	$99	299%	—	$0 – $682
4	Humana fee schedule · outpatient · +6 other terms	75	$28	$65	$134	206%	—	$9 – $716
5	Kaiser fee schedule · both · +2 other terms	43	$15	$14	$4	26%	—	$10 – $20
6	Anthem fee schedule · outpatient · +6 other terms	37	$0	$25	$125	507%	—	$0 – $682
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$52	$47	$16	33%	—	$19 – $81
8	Molina facility · case rate · outpatient · +4 other terms	27	$668	$599	$237	40%	—	$319 – $1.2k
9	Cigna fee schedule · both · +3 other terms	20	$11	$10	$1	14%	—	$7 – $11
10	Caresource facility · case rate · outpatient	15	$724	$777	$178	23%	—	$483 – $1.2k
11	Aetna Better Health fee schedule · outpatient · +2 other terms	13	$9	$9	$1	11%	—	$8 – $9
12	Optum facility · case rate · outpatient · +2 other terms	13	$643	$669	$217	32%	—	$303 – $1.1k
13	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$215	$205	$59	29%	—	$112 – $270
14	Regence fee schedule · outpatient · +1 other terms	12	$11	$12	$3	26%	—	$8 – $28
15	Medica fee schedule · outpatient · +4 other terms	10	$29	$29	$7	25%	—	$18 – $38
16	Ucare fee schedule · both	9	$7	$7	$0	3%	—	$7 – $7
17	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	7	$351	$356	$11	3%	—	$351 – $383
18	Bcbs La fee schedule · outpatient · +1 other terms	6	$14	$14	—	—	—	$14 – $14
19	Tricare facility · fee schedule · outpatient · +1 other terms	5	$16	$16	—	—	—	$16 – $16
20	First Health facility · fee schedule · outpatient	4	$36	$36	—	—	—	$36 – $36
21	Bcbs Sc fee schedule · outpatient	3	$22	$22	—	—	—	$22 – $22
22	Wellmark facility · case rate · outpatient · +1 other terms	3	$1.2k	$1.1k	$335	32%	—	$494 – $1.3k
23	Bcbs Id facility · fee schedule · outpatient	2	$15	$15	$1	4%	—	$15 – $16
24	Bcbs Vt professional · fee schedule · outpatient · +1 other terms	2	$20	$20	$5	24%	—	$12 – $28
25	Highmark fee schedule · outpatient · +1 other terms	2	$311	$534	$762	143%	—	$12 – $2.2k

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