go back

Texas rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $2 · 10th–90th $1–$50%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0

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 / $2.34 / $3.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $3.24 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.74 / $2.75
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $2.04 / $4.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.95 / $1.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.48 / $1.58