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
LEVOTHYROXINE 100 MCG IV SOLR [113060]
Low
$1
Average
$262
Median
$86
High
$2.2k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
68 hospitals; the 90th percentile is 144.5× 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.
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74 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA fee schedule · outpatient | 1 | $532 | $532 | — | — | — | $532 – $532 |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $901 | $901 | — | — | — | $901 – $901 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $383 | $383 | — | — | — | $383 – $383 |
| 4 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $744 | $744 | — | — | — | $744 – $744 |
| 5 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $126 | $126 | — | — | — | $126 – $126 |
| 6 | Bullhead City Hospital Corporation City, AZ facility · other · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 10 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · both | 3 | $109 | $109 | $36 | 33% | — | $73 – $145 |
| 11 | Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient | 2 | $254 | $254 | — | — | — | $254 – $254 |
| 12 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 13 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 14 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 16 | Grossmont Hospital Corporation La Mesa, CA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges | 1 | $396 | $396 | — | — | — | $396 – $396 |
| 18 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges | 1 | $446 | $446 | $155 | 35% | — | $291 – $601 |
| 19 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $712 | $712 | — | — | — | $712 – $712 |
| 20 | Hackettstown Medical Center Hackettstown, NJ percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 21 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 22 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 23 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 24 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $2 | $3 | $3 | 89% | — | $2 – $8 |
| 25 | Longview Medical Center LP Longview, TX facility · fee schedule · outpatient | 1 | $6 | $5 | $1 | 32% | — | $3 – $6 |
← Payers reporting HCPCS J0650 · Snapshot 20261111T120946Z-9134e7f7