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Arkansas rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.42 / $1.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.42 / $1.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.42 / $1.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.51 / $2.22