Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
leucovorin calcium per 50 mg
Low
$0
Average
$157
Median
$27
High
$3.3k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 202 hospitals; the 90th percentile is 71.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Self Regional Healthcare Greenwood, SC | $189 | $270 | $199 | 74% | 187–241 | $101 – $599 |
| 2 | PeaceHealth United General Medical Center Sedro Woolley, WA | $105 | $105 | — | — | 156 | $105 – $105 |
| 3 | Northfield Hospital Northfield, MN | $4 | $4 | — | — | 68 | $4 – $60 |
| 4 | Appalachian Regional Healthcare, Inc. Beckley, WV | $929 | $834 | $229 | 27% | 32–86 | $4 – $1.0k |
| 5 | Samaritan Medical Center Watertown, NY | $38 | $38 | $11 | 30% | 16–160 | $27 – $145 |
| 6 | Appalachian Regional Healthcare, Inc. Hazard, KY | $408 | $408 | $87 | 21% | 14–41 | $5 – $494 |
| 7 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY | $583 | $583 | $370 | 63% | 8–80 | $5 – $952 |
| 8 | Shannon Medical Center San Angelo, TX | $567 | $567 | — | — | 6–60 | $4 – $567 |
| 9 | Shannon River Crest Hospital San Angelo, TX | $567 | $567 | — | — | 6–60 | $4 – $567 |
| 10 | Shannon Medical Center Big Spring Big Spring, TX | $567 | $567 | — | — | 6–60 | $4 – $567 |
Ask Claude or any MCP client for HCPCS J0640 pricing at a specific hospital — see how to connect.