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Arkansas rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.86 / $44.32 / $338.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $3.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.44 / $7.44 / $7.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $7.44 / $7.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.22 / $3.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.41 / $8.13