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
$5
Average
$423
Median
$176
High
$1.6k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 198.9× 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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60 hospital rates
iThe hospitals that file a Tricare 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 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 2 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 3 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $128 | $156 | $47 | 30% | — | $128 – $238 |
| 4 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 5 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 6 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 7 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $629 | $629 | — | — | — | $629 – $629 |
| 8 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $133 | $133 | $30 | 23% | — | $103 – $163 |
| 9 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $887 | $1.1k | $574 | 55% | — | $443 – $2.0k |
| 10 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $887 | $1.1k | $574 | 55% | — | $443 – $2.0k |
| 11 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $459 | $459 | — | — | — | $459 – $459 |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $328 | $328 | — | — | — | $328 – $328 |
| 13 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 14 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 15 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $589 | $397 | $272 | 69% | — | $12 – $589 |
| 16 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $589 | $397 | $272 | 69% | — | $12 – $589 |
| 17 | Kaweah Health Rehabilitation Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $301 | $301 | $289 | 96% | — | $12 – $589 |
| 18 | MACON COMMUNITY HOSPITAL LAFAYETTE, TN percent of total billed charges · bothfrom % of charges | 1 | $205 | $205 | — | — | — | $205 – $205 |
| 19 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 20 | MCLAREN THUMB REGION AXE, MI fee schedule | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | McLeod Health Dillon, SC fee schedule · both | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 22 | McLeod Health Cheraw, SC fee schedule · both | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 23 | McLeod Health Manning, SC fee schedule · both | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 24 | McLeod Health Florence, SC fee schedule · both | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 25 | McLeod Health Beach, SC fee schedule · both | 1 | $7 | $7 | — | — | — | $7 – $7 |
← Payers reporting HCPCS J0650 · Snapshot 20261111T120946Z-9134e7f7