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Utah rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Facilitymedian $1 · 10th–90th $1$30%50%90th$1Professionalmedian $1 · 10th–90th $1$20%50%90th$1$1.0$2.0$5.0

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 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $1.86 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.29 / $1.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.75 / $3.09 / $3.47
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.29 / $1.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.58