Intravenous immune globulin injection, 500 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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

immune globulin 5% IV Sol 100 mL [CMH]

Payers reporting HCPCS J1572

Payer pricing summary

Low

$47

Average

$829

Median

$589

High

$4.8k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +21 other terms	572	$92	$552	$3.5k	632%	—	$0 – $30.7k
2	Aetna fee schedule · outpatient · +22 other terms	304	$91	$246	$1.3k	522%	—	$1 – $18.5k
3	Blue Cross Blue Shield fee schedule · outpatient · +23 other terms	285	$92	$252	$1.4k	568%	—	$0 – $18.1k
4	Cigna fee schedule · outpatient · +17 other terms	266	$95	$266	$690	260%	—	$0 – $8.2k
5	Humana fee schedule · outpatient · +22 other terms	213	$57	$534	$2.8k	518%	—	$0 – $18.9k
6	Anthem facility · fee schedule · outpatient · +14 other terms	112	$91	$118	$306	260%	—	$11 – $3.4k
7	WellCare fee schedule · outpatient · +12 other terms	97	$56	$899	$3.8k	428%	—	$42 – $18.7k
8	Molina fee schedule · outpatient · +20 other terms	90	$61	$129	$228	177%	—	$1 – $1.3k
9	Kaiser fee schedule · outpatient · +16 other terms	65	$173	$1.3k	$3.4k	252%	—	$1 – $18.7k
10	Ambetter facility · fee schedule · outpatient · +11 other terms	42	$129	$589	$1.4k	239%	—	$45 – $6.7k
11	Devoted facility · fee schedule · outpatient · +7 other terms	41	$91	$69	$23	33%	—	$45 – $100
12	MultiPlan fee schedule · outpatient · +15 other terms	38	$171	$2.4k	$2.9k	118%	—	$1 – $14.1k
13	Caresource fee schedule · outpatient · +12 other terms	35	$57	$376	$2.4k	647%	—	$9 – $18.7k
14	Bcbs Tx fee schedule · outpatient · +1 other terms	31	$162	$150	$67	44%	—	$42 – $289
15	Clover fee schedule · outpatient · +4 other terms	26	$57	$2.2k	$5.9k	264%	—	$49 – $18.1k
16	Regence facility · fee schedule · outpatient · +12 other terms	23	$94	$82	$18	22%	—	$41 – $96
17	Aetna Better Health fee schedule · outpatient · +13 other terms	22	$55	$53	$3	5%	—	$52 – $62
18	Optum facility · fee schedule · outpatient · +9 other terms	21	$56	$60	$12	20%	—	$45 – $91
19	Oscar facility · fee schedule · outpatient · +11 other terms	20	$75	$85	$22	26%	—	$64 – $136
20	Medical Mutual facility · fee schedule · outpatient · +6 other terms	19	$124	$139	$48	35%	—	$49 – $361
21	Medicare fee schedule · outpatient · +6 other terms	16	$73	$373	$2.4k	633%	—	$1 – $18.1k
22	Medicaid fee schedule · both · +6 other terms	15	$802	$1.2k	$645	52%	—	$60 – $2.4k
23	First Health fee schedule · outpatient · +12 other terms	14	$3.0k	$2.9k	$2.8k	96%	—	$56 – $11.6k
24	Highmark fee schedule · outpatient · +7 other terms	14	$69	$70	$28	41%	—	$30 – $149
25	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$45	$48	$13	26%	—	$21 – $57

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