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Delaware rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $660.69 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $93.33 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.55 / $9.55 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $5.75 / $8.71