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Alaska rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $1 · 10th–90th $1–$40%50%90th$1Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0

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
$1.55 / $9.12 / $9.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $4.17
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.70 / $1.70 / $5.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.51 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $1.58 / $4.27