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Leucovorin Injection

Wisconsin rates for HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Rates data updated July 2026.

Facilitymedian $15 · 10th–90th $4$420%10%10th90th$15Professionalmedian $4 · 10th–90th $4$100%50%10th90th$4$1.0$5.0$20.0$100.0

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
Setting
Facility
Modifier
Global
Typical Low
$7.24
Median
$23.99
Typical High
$45.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$4.90
Typical High
$12.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$4.47
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$3.63
Typical High
$4.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$5.89
Typical High
$10.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$4.57
Typical High
$7.08
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.24
Typical High
$7.08
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$0.54
Median
$6.46
Typical High
$6.46
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$17.78
Typical High
$23.99
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$4.47
Typical High
$6.46
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$4.79
Typical High
$6.03
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.24
Typical High
$7.08
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$0.54
Median
$6.46
Typical High
$6.46
Quartz
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$5.13
Typical High
$10.72
Quartz
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$10.96
Typical High
$165.96
Quartz
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$3.63
Typical High
$4.47
Security Health
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$4.90
United
Setting
Facility
Modifier
Global
Typical Low
$3.63
Median
$3.63
Typical High
$8.91
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$4.37
Typical High
$5.62