Octagam immune globulin IV injection, 500 mg at Metropolitan Methodist

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

IVIG OCTAGAM 10 G

SAN ANTONIO, TX

See all payers reporting HCPCS J1568 →

Payers reporting HCPCS J1568 at Metropolitan Methodist

Negotiated rates from the hospital’s own file: 6 payers, 23 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	UnitedHealthcare allpayerappendix fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
2	UnitedHealthcare charter fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
3	UnitedHealthcare nexusaco fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
4	UnitedHealthcare smallgroup fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
5	Cigna newbusinessnetwork fee schedule · outpatient	$81	$81	—	—	—	$81 – $81
6	Cigna hmo fee schedule · outpatient	$89	$89	—	—	—	$89 – $89
7	Cigna openaccessplus fee schedule · outpatient	$89	$89	—	—	—	$89 – $89
8	Cigna ppo fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
9	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$137	$137	—	—	—	$137 – $137
10	Blue Cross Blue Shield blueadvantage fee schedule · outpatient	$158	$158	—	—	—	$158 – $158
11	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$215	$215	—	—	—	$215 – $215
12	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$215	$215	—	—	—	$215 – $215
13	Blue Cross Blue Shield healthselectopenaccess(eposoa) fee schedule · outpatient	$235	$235	—	—	—	$235 – $235
14	Blue Cross Blue Shield ppo fee schedule · outpatient	$256	$256	—	—	—	$256 – $256
15	First Health chip percent of total billed charges · outpatientfrom % of charges	$1.2k	$1.2k	$552	47%	—	$454 – $1.8k
16	First Health chipperinate percent of total billed charges · outpatientfrom % of charges	$1.2k	$1.2k	$552	47%	—	$454 – $1.8k
17	First Health mcdstar percent of total billed charges · outpatientfrom % of charges	$1.2k	$1.2k	$552	47%	—	$454 – $1.8k
18	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$2.5k	$2.4k	$1.1k	47%	—	$931 – $3.7k
19	Blue Cross Blue Shield trad percent of total billed charges · outpatientfrom % of charges	$3.1k	$2.9k	$1.4k	47%	—	$1.1k – $4.4k
20	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$4.7k	$4.4k	$2.1k	47%	—	$1.7k – $6.7k
21	Aetna asa percent of total billed charges · outpatientfrom % of charges	$5.2k	$4.9k	$2.3k	47%	—	$1.9k – $7.5k
22	MultiPlan phcsprimarynetwork percent of total billed charges · outpatientfrom % of charges	$7.8k	$7.4k	$3.5k	47%	—	$2.8k – $11.2k
23	MultiPlan complementarynetwork percent of total billed charges · outpatientfrom % of charges	$8.8k	$8.4k	$3.9k	47%	—	$3.2k – $12.7k