HCPCS J1572
Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
Current codeInjection - Immune Globulin33 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $1,240 – $1,836 | — | — |
| Deaconess Medical Center | $1,134 – $1,201 | — | — |
| Harborview Medical Center | — | — | — |
| Island Hospital | $1,170 – $1,270 | — | — |
| Kadlec Regional Medical Center | — | $2,312 – $4,624 | $3,303 – $6,606 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | $1,173 – $1,267 | — | — |
| MultiCare Auburn Medical Center | $1,152 – $1,244 | — | — |
| MultiCare Covington Medical Center | $1,152 – $1,244 | — | — |
| MultiCare Good Samaritan Hospital | $1,178 – $1,273 | — | — |
| MultiCare Valley Hospital | $1,126 – $1,192 | — | — |
| Olympic Medical Center | $1,450 – $1,588 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| PeaceHealth Peace Island Medical Center | — | $855 – $2,860 | $1,316 – $4,400 |
| PeaceHealth Southwest Medical Cente | $94.37 | $855 – $2,860 | $1,316 – $4,400 |
| PeaceHealth St John Medical Center | $70.78 – $95.28 | $855 – $2,860 | $1,316 – $4,400 |
| PeaceHealth St Joseph Medical Center | $95.28 | $855 – $2,860 | $1,316 – $4,400 |
| PeaceHealth United General Medical Center | — | $855 – $2,860 | $1,316 – $4,400 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | $1,541 – $5,502 | $2,964 – $10,580 |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | $1,175 | $2,259 |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | $1,541 | $2,964 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | $1,179 – $1,273 | — | — |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $62.58 – $97.57 | $123 – $191 |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $1,127 – $1,309 | — | — |
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)
- $90.74 (APC 0947)
- Surgery center payment (national)
- $90.74