LEVOLEUCOVORIN CALCIUM 50 MG INTRAVENOUS POWDER FOR SOLUTION

Reported by 28 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

Average

$375

Median

$24

High

$1.1k

#	Hospital	Location
1	Scl Health - Montana, Dba Intermountain Health St. Vincent Healthcare	Billings, MT	$421	$528	$296	—	$168	$955
2	Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph Hospital	DENVER, CO	$49	$150	$176	—	$0	$532
3	Intermountain Front Range Inc. Dba Intermountain Health Lutheran Hospital	WHEAT RIDGE, CO	$0	$0	—	—	$0	$50
4	Good Samaritan Medical Center, Llc Dba	LAFAYETTE, CO	$0	$0	—	—	$0	$50
5	St. James Healthcare INTERMOUNTAIN HEALTH ST JAMES HOSPITAL	Butte, MT	$296	$278	$36	—	$80	$318
6	Indiana University Health West Hospital Inc.	Avon, IN	$18	$18	$4	—	$0	$22
7	Indiana University Health North Hospital Inc.	Carmel, IN	$18	$18	$4	—	$0	$22
8	Indiana University Health Inc.	Indianapolis, IN	$18	$18	$4	—	$0	$22
9	Indiana University Health Paoli Inc.	Paoli, IN	$21	$19	$4	—	$0	$23
10	Indiana University Health Bloomington Inc.	Bloomington, IN	$20	$19	$4	—	$0	$23

Page 1 of 3

Ask Claude or any MCP client for CPT J0641 pricing at a specific hospital — see how to connect.