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Connecticut rates for HCPCS J0642

Injection Levoleucovorin (Khapzory) 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.79 / $3.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $1.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $2.16 / $4.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.47 / $1.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.50 / $2.40