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Pennsylvania rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Facilitymedian $0 · 10th–90th $0–$30%20%10th90th$0Professionalmedian $3 · 10th–90th $0–$2950%20%10th90th$3$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.75 / $2.75
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $169.82 / $295.12
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.05 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.18 / $0.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.09 / $0.09
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.31
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.20 / $0.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.21 / $0.21 / $0.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.06 / $0.09