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Minnesota rates for HCPCS J0642

Injection Levoleucovorin (Khapzory) 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $2.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $5.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.06 / $1.93 / $4.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $1.12 / $1.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $4.42 / $5.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.52 / $1.63
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.22 / $4.03 / $5.05
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.83 / $3.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.25 / $2.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.58 / $2.72