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Indiana rates for HCPCS J0640

Leucovorin Calcium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.99 / $59.40 / $433.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $7.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.38 / $6.44 / $9.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.73 / $3.22 / $4.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $3.22 / $4.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $11.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $4.47 / $6.44