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Missouri rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.85 / $77.42 / $530.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.28 / $7.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.51 / $5.47 / $8.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $4.03
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.03 / $9.08 / $164.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $3.95 / $4.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $4.74