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New Hampshire rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.09 / $0.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06