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Michigan rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.14 / $0.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $1.68
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.09 / $0.39
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.08