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Louisiana rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.25 / $11.77 / $657.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $4.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $16.14 / $18.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.86 / $3.86 / $3.94
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $60.70 / $60.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $4.53