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Oregon rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $2.04 / $3.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $2.29 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $2.88 / $3.39
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.51 / $1.70
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.51 / $1.70
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.78 / $2.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $2.29 / $3.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.45 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $2.75 / $5.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.58