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North Carolina rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.33 / $0.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.35 / $0.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.41
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 / $0.39
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.35 / $0.43
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $1.36 / $1.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00