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New Jersey rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $1.58 / $3.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.73 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $8,702.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.54 / $2.61