go back

Minnesota rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $7.08 / $7.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.06 / $0.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.05 / $0.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.33 / $0.85
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.07 / $1.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.11