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South Carolina rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $2 · 10th–90th $1–$60%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0

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
$1.00 / $2.00 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.69 / $5.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $2.14 / $2.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $3.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.48 / $1.78 / $3.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.45 / $1.58