go back

Levoleucovorin (Khapzory) Injection

Utah rates for HCPCS J0642

Injection, levoleucovorin (Khapzory), 0.5 mg

Rates data updated July 2026.

Facilitymedian $2 · 10th–90th $2$30%50%90th$2Professionalmedian $2 · 10th–90th $1$20%50%10th$2$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
Setting
Facility
Modifier
Global
Typical Low
$1.51
Median
$1.51
Typical High
$1.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$1.51
Typical High
$1.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.38
Median
$1.86
Typical High
$2.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.29
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2.75
Median
$3.09
Typical High
$3.47
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.29
Typical High
$1.70
United
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.41
Typical High
$1.58