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Levoleucovorin (Khapzory) Injection

Texas rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Rates data updated July 2026.

Facilitymedian $2 · 10th–90th $1$40%20%10th90th$2Professionalmedian $1 · 10th–90th $1$20%50%10th90th$1$1.0$5.0$20.0$100.0$500.0

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
$1.58
Typical High
$3.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.32
Typical High
$1.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$3.24
Typical High
$8.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.29
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$1.45
Typical High
$2.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.29
Typical High
$2.57
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$2.04
Typical High
$4.07
Providence
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.29
United
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$2.14
Typical High
$2.34
United
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.58
Typical High
$1.58
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.35
Typical High
$1.74