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Washington rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Facilitymedian $0 · 10th–90th $0–$10%10%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$2950%20%40%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$1.17 / $1.17 / $1.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $169.82 / $295.12
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.05 / $0.16
Asuris Northwest Health
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 / $0.08 / $0.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.06
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.06 / $0.37
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.05 / $0.32
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.05 / $0.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.04 / $0.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.05 / $0.05
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.07