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West Virginia rates for HCPCS J0640

Leucovorin Calcium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.14 / $95.64 / $510.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.25 / $3.99
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.22 / $3.95 / $4.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $7.46 / $7.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.22 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.22 / $8.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.24 / $12.48 / $96.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.61 / $9.01