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.
Original text from hospital filings
RHO(D) IMMUNE GLOBULIN 250 UNIT (50 MCG) INTRAMUSCULAR SYRINGE
Low
$59
Average
$144
Median
$165
High
$204
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 2.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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15 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 2 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 3 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 4 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $204 | $204 | — | — | — | $204 – $204 |
| 5 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 6 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 7 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 8 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 9 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 10 | OCHSNER BAYOU LLC Raceland, LA percent of total billed charges · outpatientfrom % of charges | 1 | $94 | $94 | $5 | 5% | — | $89 – $99 |
| 11 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 12 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 13 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 14 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 15 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
← Payers reporting HCPCS J2788 · Snapshot 20261111T120946Z-9134e7f7