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Levoleucovorin (Khapzory) Injection

New Hampshire rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Rates data updated July 2026.

Facilitymedian $2 · 10th–90th $1$50%20%10th90th$2Professionalmedian $1 · 10th–90th $1$20%50%90th$1$2.0$5.0

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
Setting
Facility
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.45
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.82
Median
$2.69
Typical High
$4.68
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.51
Typical High
$3.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.29
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$2.14
Typical High
$2.45
United
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.41
Typical High
$2.04