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Nebraska rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.35 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.14 / $0.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.31 / $2.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.07