Levoleucovorin injection, 0.5 mg

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Levoleucovorin 50MG IFC (FUSIL)Rnd 0.5mg

Payers reporting HCPCS J0641

Payer pricing summary

Low

Average

$204

Median

$150

High

$955

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +21 other terms	436	$0	$14	$109	786%	—	$0 – $1.3k
2	Cigna fee schedule · outpatient · +16 other terms	310	$0	$73	$549	757%	—	$0 – $7.9k
3	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	264	$0	$1	$1	141%	—	$0 – $11
4	Aetna fee schedule · outpatient · +18 other terms	200	$0	$62	$272	436%	—	$0 – $2.3k
5	Humana fee schedule · outpatient · +15 other terms	165	$0	$141	$397	282%	—	$0 – $1.8k
6	Anthem fee schedule · outpatient · +18 other terms	94	$0	$2	$12	726%	—	$0 – $194
7	Caresource fee schedule · outpatient · +9 other terms	56	$0	$0	$0	57%	—	$0 – $0
8	Kaiser fee schedule · both · +13 other terms	47	$0	$0	$1	529%	—	$0 – $7
9	Molina facility · case rate · outpatient · +16 other terms	42	$28	$129	$159	123%	—	$0 – $547
10	MultiPlan fee schedule · outpatient · +11 other terms	32	$190	$377	$650	172%	—	$0 – $2.1k
11	Bcbs Tx fee schedule · outpatient · +2 other terms	30	$1	$1	$0	33%	—	$0 – $2
12	Medcost percent of total billed charges · outpatientfrom % of charges · +3 other terms	21	$508	$346	$255	74%	—	$2 – $926
13	Regence professional · fee schedule · outpatient · +6 other terms	21	$0	$0	$0	16%	—	$0 – $0
14	Oscar facility · fee schedule · outpatient · +8 other terms	20	$0	$0	$0	133%	—	$0 – $0
15	Healthpartners fee schedule · outpatient · +2 other terms	18	$0	$0	—	—	—	$0 – $0
16	Aetna Better Health fee schedule · outpatient · +7 other terms	17	$0	$0	$0	115%	—	$0 – $0
17	WellCare professional · fee schedule · outpatient · +7 other terms	14	$0	$0	$0	17%	—	$0 – $0
18	Wellmark fee schedule · both · +4 other terms	14	$0	$0	—	—	—	$0 – $0
19	Medical Mutual facility · fee schedule · outpatient · +4 other terms	13	$0	$0	$0	33%	—	$0 – $0
20	Optum facility · case rate · outpatient · +6 other terms	13	$292	$286	$132	46%	—	$22 – $495
21	Bcbs Mn fee schedule · outpatient · +5 other terms	12	$0	$0	$0	60%	—	$0 – $0
22	First Health fee schedule · outpatient · +10 other terms	12	$723	$820	$728	89%	—	$1 – $1.8k
23	Highmark fee schedule · outpatient · +5 other terms	12	$0	$0	$0	50%	—	$0 – $0
24	Bcbs Nj fee schedule · outpatient · +2 other terms	11	$0	$0	$0	25%	—	$0 – $0
25	Medica fee schedule · outpatient · +7 other terms	10	$0	$0	$0	29%	—	$0 – $0

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