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Vermont rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $389.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.98 / $5.89