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Minnesota rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $3.22 / $138.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.99 / $158.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $3.81 / $8.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $3.95 / $4.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.05 / $6.31 / $13.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $4.51 / $4.88
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.90 / $10.44 / $15.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $3.56 / $4.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $10.30 / $21.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.47 / $7.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.67 / $6.16