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Connecticut rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $87.10 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $10.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $6.03 / $10.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.72 / $4.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $4.07 / $8.13