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Washington, DC rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.33 / $15.01 / $389.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $6.90 / $11.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.74 / $2.74 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $3.64 / $4.74