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Iowa rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.69 / $2.66 / $3.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.88 / $5.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.41 / $1.50
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.62 / $6.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.78 / $2.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.25 / $2.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.78 / $2.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.69 / $4.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.46 / $1.69
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12