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Missouri 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 / $0.34 / $0.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $1.49 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08