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
IG FLEBOGA5GM/100MLIVJWTB
Northridge, CA
See all hospitals reporting HCPCS J1572 →Price type
Dignity Community Care’s median price of $76 is 16% below the median hospital's median price ($91), higher than 43% 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: 10 payers, 29 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 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 2 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 3 | Aetna medicare|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 4 | Anthem medicare|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 5 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 6 | First Health commercial|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 7 | Humana commercial|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 8 | Humana medicare|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 9 | Kaiser medicare|all plans fee schedule · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 10 | Molina medicare|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 11 | UnitedHealthcare medicare|all plans case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 12 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $73 | $73 | — | — | — | $73 – $73 |
| 13 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $73 | $73 | — | — | — | $73 – $73 |
| 14 | Anthem medicaid|< 21 fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 15 | Anthem medicaid|> 21 fee schedule · outpatient | $76 | $76 | — | — | — | $76 – $76 |
| 16 | Molina medicaid|< 21 fee schedule · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 17 | Molina medicaid|> 21 fee schedule · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 18 | Anthem commercial|all other plans fee schedule · outpatient | $111 | $111 | — | — | — | $111 – $111 |
| 19 | Aetna commercial|all other plans fee schedule · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 20 | Aetna commercial|hmo fee schedule · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 21 | Aetna commercial|ppo fee schedule · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 22 | Anthem commercial|mcs fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 23 | Anthem commercial|vivity fee schedule · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 24 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $287 | $287 | — | — | — | $287 – $287 |
| 25 | Cigna commercial|all other plans fee schedule · outpatient | $839 | $839 | $17 | 2% | — | $822 – $855 |
Last updated: Feb 28, 2026
See Intravenous immune globulin injection, 500 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.