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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
$3.22 / $80.93 / $472.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.35 / $4.42
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $9.86 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.41 / $7.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $4.11 / $8.76
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 / $3.22
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.83 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $6.83
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.48 / $30.12 / $147.08
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $164.71
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.41 / $7.66
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.32 / $1.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.83 / $7.66