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North Dakota rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $5.79 / $1,282.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $4.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.49 / $3.51 / $3.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.97 / $3.50 / $3.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $3.56 / $4.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.91 / $4.70 / $9.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $4.47 / $4.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.67 / $4.84