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Vermont rates for HCPCS J0640

Leucovorin Calcium Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.57 / $6.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.64 / $3.64 / $3.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.98 / $6.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $3.22
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.98 / $6.63
MVP Health Care
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 / $7.66