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Levoleucovorin (Khapzory) Injection

Indiana rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Rates data updated July 2026.

Facilitymedian $2 · 10th–90th $1$40%20%10th90th$2Professionalmedian $1 · 10th–90th $1$20%50%10th90th$1$1.0$2.0$5.0$10.0

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
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$3.31
Typical High
$6.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.32
Typical High
$1.32
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.51
Median
$1.95
Typical High
$2.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$2.09
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$2.14
Typical High
$2.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$3.55
Typical High
$3.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.66
United
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$2.14
Typical High
$2.14
United
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.58
Typical High
$2.82