Levothyroxine sodium injection, 10 mcg

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

LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION

Payers reporting HCPCS J0651

Payer pricing summary

Low

Average

$164

Median

$87

High

$1.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +25 other terms	590	$10	$24	$62	258%	—	$0 – $1.0k
2	Aetna fee schedule · outpatient · +20 other terms	373	$7	$34	$83	242%	—	$0 – $768
3	Cigna fee schedule · outpatient · +20 other terms	311	$10	$34	$62	182%	—	$0 – $874
4	Humana fee schedule · outpatient · +20 other terms	306	$7	$29	$57	194%	—	$0 – $391
5	Blue Cross Blue Shield fee schedule · outpatient · +25 other terms	291	$10	$27	$53	198%	—	$1 – $618
6	Molina fee schedule · outpatient · +20 other terms	126	$9	$22	$34	154%	—	$1 – $301
7	Anthem facility · fee schedule · outpatient · +20 other terms	120	$8	$22	$60	272%	—	$1 – $970
8	WellCare fee schedule · outpatient · +15 other terms	115	$7	$7	$7	94%	—	$0 – $67
9	Ambetter facility · fee schedule · outpatient · +13 other terms	73	$13	$14	$15	105%	—	$4 – $147
10	Devoted fee schedule · outpatient · +10 other terms	61	$7	$6	$1	22%	—	$4 – $7
11	Caresource fee schedule · outpatient · +13 other terms	59	$7	$10	$10	102%	—	$0 – $67
12	Kaiser fee schedule · outpatient · +16 other terms	57	$10	$39	$61	157%	—	$7 – $523
13	MultiPlan fee schedule · outpatient · +11 other terms	51	$147	$199	$186	94%	—	$0 – $1.0k
14	Optum facility · fee schedule · outpatient · +17 other terms	48	$7	$21	$51	249%	—	$4 – $347
15	Medica fee schedule · outpatient · +15 other terms	33	$8	$151	$143	95%	—	$0 – $911
16	Oscar facility · fee schedule · outpatient · +11 other terms	33	$9	$9	$2	20%	—	$7 – $13
17	Medicare fee schedule · outpatient · +11 other terms	29	$7	$6	$0	2%	—	$6 – $8
18	Bcbs Tx fee schedule · outpatient · +2 other terms	27	$37	$34	$15	45%	—	$4 – $61
19	Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms	25	$9	$9	$2	20%	—	$7 – $11
20	Highmark facility · fee schedule · outpatient · +9 other terms	25	$8	$10	$6	58%	—	$3 – $24
21	Clover fee schedule · outpatient · +6 other terms	24	$5	$6	$1	23%	—	$4 – $8
22	Superior Healthplan facility · fee schedule · outpatient · +3 other terms	23	$7	$7	$1	13%	—	$7 – $12
23	Medicaid facility · fee schedule · outpatient · +10 other terms	20	$15	$23	$37	158%	—	$6 – $191
24	Medical Mutual facility · fee schedule · outpatient · +6 other terms	20	$10	$14	$7	51%	—	$4 – $30
25	Regence facility · fee schedule · outpatient · +7 other terms	20	$7	$8	$4	47%	—	$4 – $19

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