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.
Generation details were not recorded for this description.
Original text from hospital filings
Immune Glob Gammagard 5GR/50ML
Mitchell, SD
See all hospitals reporting HCPCS J1569 →Price type
Avera Queen of Peace’s median price of $51 is 45% below the median hospital's median price ($92), higher than 23% of the 1,990 hospitals reporting HCPCS J1569. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica com fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 2 | Medica ind fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 3 | Wellmark ppo fee schedule · outpatient | $45 | $45 | — | — | — | $45 – $45 |
| 4 | Healthpartners com fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 5 | Medica ind percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | $372 | 32% | — | $792 – $1.5k |
| 6 | Medica com percent of total billed charges · inpatientfrom % of charges | $1.4k | $1.4k | $438 | 32% | — | $931 – $1.8k |
| 7 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | $506 | 32% | — | $1.1k – $2.1k |
| 8 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | $506 | 32% | — | $1.1k – $2.1k |
Last updated: Apr 1, 2026
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