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Ohio 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
$1.41 / $2.63 / $3.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $2.75 / $8.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.55 / $2.57
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.57 / $4.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.41
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $3.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.78 / $2.04
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $2.19 / $3.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $2.51 / $2.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.58 / $1.74