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South Dakota rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Facilitymedian $4 · 10th–90th $3$1380%50%10th90th$4Professionalmedian $4 · 10th–90th $3$50%20%40%10th90th$4$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $7.76 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.89 / $4.79
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.55 / $3.55 / $3.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $4.90
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $6.61 / $10.72
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.47 / $4.47
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $4.79 / $4.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $4.17 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $3.80 / $4.47
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $3.80