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Kansas rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.13 / $2.45 / $4.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.53 / $2.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $2.09 / $2.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.54 / $1.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $1.70 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.19 / $2.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.51 / $2.61