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Arizona rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $3 · 10th–90th $2–$80%10%10th90th$3Professionalmedian $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
$2.04 / $2.51 / $4.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $4.79 / $8.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $2.69 / $9.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $2.14 / $2.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $1.48 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.29 / $1.95 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.41 / $1.58