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
FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION
Eureka, IL
See all hospitals reporting HCPCS J1572 →Price type
Carle Eureka Hospital’s median price of $2.4k is 2578% above the median hospital's median price ($91), higher than 95% of the 1,325 hospitals reporting HCPCS J1572. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 20 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 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $51 | $51 | — | — | — | $51 – $51 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 3 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $52 | $52 | — | — | — | $52 – $52 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 5 | WellCare medicare advantage hmo case rate · outpatient | $91 | $91 | — | — | — | $91 – $91 |
| 6 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | $1.0k | 64% | — | $394 – $3.2k |
| 7 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | $1.0k | 64% | — | $394 – $3.2k |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | $1.0k | 64% | — | $394 – $3.2k |
| 9 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.7k | $2.3k | 64% | — | $886 – $7.1k |
| 10 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.7k | $2.3k | 64% | — | $886 – $7.1k |
| 11 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.7k | $2.3k | 64% | — | $886 – $7.1k |
| 12 | UnitedHealthcare va ccn/optum percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.7k | $2.3k | 64% | — | $886 – $7.1k |
| 13 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $3.8k | $3.9k | $2.5k | 64% | — | $945 – $7.6k |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $4.9k | $5.0k | $3.2k | 64% | — | $1.2k – $9.7k |
| 15 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $4.9k | $5.1k | $3.2k | 64% | — | $1.2k – $9.8k |
| 16 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $5.2k | $5.4k | $3.4k | 64% | — | $1.3k – $10.4k |
| 17 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $5.2k | $5.4k | $3.4k | 64% | — | $1.3k – $10.4k |
| 18 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $5.3k | $5.5k | $3.5k | 64% | — | $1.3k – $10.6k |
| 19 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $5.9k | $6.1k | $3.9k | 64% | — | $1.5k – $11.8k |
| 20 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $6.6k | $6.9k | $4.4k | 64% | — | $1.7k – $13.2k |
Last updated: Apr 15, 2026
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