HyQvia 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-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

HYQVIA 10 GM-100ML SC KIT

Payers reporting HCPCS J1575

Payer pricing summary

Low

$10

Average

$1.8k

Median

$523

High

$16.3k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +17 other terms	572	$27	$163	$1.4k	871%	—	$3 – $22.7k
2	Aetna fee schedule · outpatient · +18 other terms	365	$21	$40	$164	411%	—	$10 – $2.4k
3	Humana fee schedule · outpatient · +16 other terms	333	$18	$131	$996	762%	—	$6 – $14.1k
4	Cigna fee schedule · outpatient · +17 other terms	328	$26	$41	$34	82%	—	$15 – $157
5	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	324	$27	$159	$1.6k	978%	—	$1 – $22.0k
6	Molina fee schedule · outpatient · +13 other terms	126	$22	$92	$567	616%	—	$12 – $6.6k
7	WellCare fee schedule · outpatient · +7 other terms	120	$18	$20	$6	29%	—	$17 – $41
8	Anthem fee schedule · outpatient · +14 other terms	106	$26	$52	$234	449%	—	$15 – $2.4k
9	Caresource fee schedule · outpatient · +7 other terms	69	$23	$23	$5	20%	—	$18 – $35
10	Devoted fee schedule · outpatient · +3 other terms	66	$18	$18	$1	5%	—	$17 – $20
11	Kaiser fee schedule · outpatient · +11 other terms	62	$21	$32	$20	62%	—	$15 – $125
12	Ambetter facility · fee schedule · outpatient · +7 other terms	51	$32	$35	$7	22%	—	$18 – $45
13	MultiPlan fee schedule · outpatient · +10 other terms	33	$29	$4.5k	$8.6k	192%	—	$11 – $22.7k
14	Optum fee schedule · outpatient · +7 other terms	33	$18	$24	$11	44%	—	$16 – $53
15	Bcbs Tx fee schedule · outpatient · +2 other terms	31	$48	$45	$19	42%	—	$17 – $85
16	Medica fee schedule · outpatient · +8 other terms	31	$32	$3.0k	$7.0k	231%	—	$6 – $22.2k
17	Clover fee schedule · outpatient · +5 other terms	29	$19	$19	$1	5%	—	$17 – $21
18	Oscar facility · fee schedule · outpatient · +9 other terms	25	$24	$26	$5	18%	—	$18 – $34
19	Medicare fee schedule · outpatient · +5 other terms	24	$18	$18	$1	3%	—	$15 – $18
20	Regence facility · fee schedule · outpatient · +3 other terms	24	$19	$20	$2	11%	—	$15 – $24
21	Aetna Better Health fee schedule · outpatient · +7 other terms	22	$18	$18	$1	5%	—	$17 – $21
22	Healthpartners fee schedule · outpatient · +5 other terms	22	$21	$20	$1	7%	—	$18 – $22
23	Medical Mutual facility · fee schedule · outpatient · +3 other terms	21	$34	$38	$18	47%	—	$10 – $78
24	Wellmark fee schedule · outpatient · +9 other terms	19	$18	$18	$0	1%	—	$17 – $18
25	Highmark fee schedule · outpatient · +6 other terms	16	$24	$64	$438	681%	—	$10 – $6.6k

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