go back

Washington, DC rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $14.45 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $3.02 / $165.96
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $6.17 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.80 / $3.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.24 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $4.07 / $5.62