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Washington, DC rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $3.16 / $4.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.64 / $4.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.51 / $2.09