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Michigan rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $3 · 10th–90th $1$40%10%10th90th$3Professionalmedian $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
$1.45 / $2.82 / $4.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $3.16 / $6.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.45 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $2.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.82 / $4.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.45 / $2.19
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $2.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.58 / $1.86