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Leucovorin Injection

Montana rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Rates data updated July 2026.

Facilitymedian $6 · 10th–90th $4$470%20%10th90th$6Professionalmedian $4 · 10th–90th $3$110%20%40%10th90th$4$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$9.12
Median
$42.66
Typical High
$47.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$3.98
Typical High
$11.22
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$46,773.51
Typical High
$89,125.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$9.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$3.63
Typical High
$3.98
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$5.50
Typical High
$13.49
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$5.50
Typical High
$13.49
Providence
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$9.33
Providence
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$5.13
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$3.80