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West Virginia rates for HCPCS J0641

Injection, levoleucovorin, not otherwise specified, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.09 / $2.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $1.74 / $1.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.83