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Mississippi rates for HCPCS J0642

Injection Levoleucovorin (Khapzory) 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.49 / $1.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.66 / $1.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.35 / $1.42 / $1.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.87