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South Carolina rates for HCPCS J0640

Leucovorin Calcium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.37 / $211.16 / $892.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.38 / $4.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $3.12 / $5.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.35 / $10.19
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.38 / $4.47 / $10.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.41 / $4.47