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Washington rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Facilitymedian $49 · 10th–90th $4$5130%10%20%10th90th$49Professionalmedian $7 · 10th–90th $3$2190%10%10th90th$7$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
$4.17 / $48.98 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $12.30 / $218.78
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $4.37
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $3.72 / $7.24
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $7.94
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $6.03 / $6.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.55 / $3.55 / $8.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $3.80 / $4.17
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.80 / $5.01