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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
$4.09 / $687.68 / $980.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $9.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.05 / $22.05 / $75.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.41 / $4.83 / $8.83