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Oklahoma rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.86 / $1.36
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 / $1.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.09 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.07