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West Virginia rates for HCPCS J0641

Levoleucovorin Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.06 / $0.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.09 / $0.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.06 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $1.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.98