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Rhode Island rates for HCPCS J0640

Leucovorin Calcium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $98.83 / $427.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $3.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $3.95 / $8.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.22 / $3.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.41 / $19.14