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Utah rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Facilitymedian $98 · 10th–90th $13–$4570%10%20%10th90th$98Professionalmedian $4 · 10th–90th $3–$50%20%10th90th$4$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$57.54 / $100.00 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $4.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $5.13 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $3.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.63 / $4.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $4.37