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Indiana rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.18 / $0.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.12 / $0.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.09
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.10