Levamisole oral tablet, 50 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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Levamisole HCl, oral, 50 mg

Payers reporting HCPCS S0177

Payer pricing summary

Low

Average

$16

Median

$10

High

$55

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +5 other terms	181	$6	$9	$7	71%	—	$3 – $26
2	Aetna fee schedule · outpatient · +8 other terms	91	$10	$11	$8	74%	—	$4 – $55
3	Humana fee schedule · outpatient · +5 other terms	71	$12	$20	$13	63%	—	$4 – $36
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	48	$6	$10	$7	76%	—	$5 – $28
5	Kaiser fee schedule · both · +1 other terms	43	$6	$5	$1	27%	—	$4 – $8
6	UnitedHealthcare fee schedule · both · +8 other terms	26	$4	$4	$1	18%	—	$4 – $7
7	Anthem facility · case rate · outpatient · +6 other terms	15	$47	$52	$12	23%	—	$32 – $80
8	Caresource facility · case rate · outpatient · +1 other terms	15	$48	$52	$12	23%	—	$32 – $82
9	Molina facility · case rate · outpatient · +2 other terms	15	$47	$52	$12	23%	—	$33 – $80
10	Highmark fee schedule · outpatient · +3 other terms	11	$2	$3	$10	325%	—	$2 – $98
11	Optum facility · case rate · outpatient	11	$45	$49	$11	22%	—	$40 – $73
12	Medica fee schedule · outpatient · +4 other terms	10	$8	$8	$2	25%	—	$5 – $10
13	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$5	$5	—	—	—	$5 – $5
14	Bcbs La fee schedule · outpatient · +1 other terms	6	$7	$7	—	—	—	$7 – $7
15	First Health facility · fee schedule · outpatient · +1 other terms	4	$16	$16	—	—	—	$16 – $16
16	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$7	$7	—	—	—	$7 – $7
17	Bcbs Ca fee schedule · outpatient · +1 other terms	1	$6	$6	—	—	—	$6 – $6
18	Bcbs Il professional · fee schedule · both	1	$6	$6	—	—	—	$6 – $6
19	Bcbs Nv fee schedule · outpatient	1	$4	$4	—	—	—	$4 – $4
20	Bcbs Vt professional · fee schedule · outpatient	1	$5	$5	—	—	—	$5 – $5
21	Healthpartners facility · fee schedule · outpatient	1	$13	$13	—	—	—	$13 – $13
22	MultiPlan fee schedule · both · +2 other terms	1	$6	$6	—	—	—	$6 – $6
23	Phcs professional · fee schedule · both	1	$6	$6	—	—	—	$6 – $6
24	Wellmark case rate · outpatient · +1 other terms	1	$18	$18	—	—	—	$18 – $18