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Iowa rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.36 / $4.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.32 / $2.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $1.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.06
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06