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Indiana rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $2 · 10th–90th $1–$40%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.95 / $6.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.95 / $2.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $2.45
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.14 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $3.55 / $3.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.58 / $2.82