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New Mexico rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $5.89 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.98 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $3.39 / $4.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $1.41 / $7.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $3.80 / $3.80