HCPCS J1569

Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg

Current codeInjection - Immune Globulin38 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

Prices for HCPCS J1569 by hospital
Hospital	Medicaid (state program) rates (lowest – highest)	Cash price	List price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27	—	$68.53 – $82.54	$171 – $206
Cascade Valley HospitalArlington	—	$1,774 – $29,855	$2,217 – $37,319
Deaconess Medical CenterSpokaneFile dated 2026-08-27	—	$57.71 – $160	$144 – $399
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01	—	$938 – $3,752	$1,340 – $5,359
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27	—	$84.83 – $134	$212 – $334
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27	—	$68.53 – $104	$171 – $259
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27	—	$68.54 – $73.20	$171 – $183
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27	—	$68.53 – $82.54	$171 – $206
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27	—	$92.34 – $113	$231 – $281
Olympic Medical CenterPort AngelesFile dated 2026-06-24	—	$2,113 – $5,473	$2,641 – $6,841
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01	—	$1,023 – $6,143	$1,462 – $8,776
Providence Centralia HospitalCentraliaFile dated 2026-04-01	—	$347 – $6,652	$668 – $12,793
Providence Holy Family HospitalSpokaneFile dated 2026-04-01	—	$1,023 – $6,143	$1,462 – $8,776
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01	—	$1,023 – $6,139	$1,462 – $8,770
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$972	$1,868
Providence St Joseph HospitalChewelahFile dated 2026-04-01	—	$1,023 – $6,139	$1,462 – $8,770
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01	—	$2,189 – $6,610	$3,128 – $9,443
Providence St Peter HospitalOlympiaFile dated 2026-04-01	—	$347 – $6,652	$668 – $12,793
Seattle Children's HospitalSeattle	$3,3171 plan	$13,161	$13,161
Skagit Valley HospitalMount Vernon	—	$1,774 – $29,855	$2,217 – $37,319
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01	—	$996 – $5,978	$2,074 – $12,454
Swedish IssaquahIssaquahFile dated 2026-04-01	—	$996 – $5,978	$2,074 – $12,454
Swedish Medical CenterSeattleFile dated 2026-04-01	—	$199 – $5,978	$415 – $12,454
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01	—	$996 – $5,974	$2,074 – $12,446
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27	—	$68.53 – $82.54	$171 – $206
Virginia Mason Medical CenterSeattle	—	$73.71 – $86.45	$145 – $170
Yakima Valley MemorialYakimaFile dated 2026-08-27	—	$68.54 – $106	$171 – $264

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Hospital outpatient payment (national): $49.50 (APC 0944)
Surgery center payment (national): $49.50