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Massachusetts rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $75.86 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $95.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $10.96 / $61.66
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.80 / $7.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $7.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.57 / $56.23 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.63 / $7.24
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $70.79 / $234.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $10.96 / $61.66
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.80 / $7.59
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $5.75 / $7.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $4.07 / $7.59