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Virginia rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.05
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 / $0.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.07 / $0.98
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.34 / $1.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.37
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08