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  5. /Percent of billed charges

NDC 143936801

Leucovorin Calcium For Inj 200 MG

Reported by 8 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Based on 2–20 billing samples across every hospital reporting.

Low

$26

Average

$38

Median

$32

High

$64

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1Sanford Fargo Medical CenterFargo, ND$27$26$81–10$1$34
2Sanford Medical Center BismarckBismarck, ND$29$28$81–10$12$35
3Sanford Behavioral Health Thief River FallsThief River Falls, MN$39$36$11—$18$49
4Sanford Aberdeen Medical CenterAberdeen, SD$69$64$13—$37$77
5Sanford Worthington Medical CenterWorthington, MN$65$58$17—$1$80
6Sanford Thief River Falls Medical CenterThief River Falls, MN$39$36$11—$18$49
7IHC Health Services Inc., DBA Intermountain Health Layton HospitalLayton, UT$30$28$8—$2$43
8IHC Health Services Inc., DBA Intermountain Health Riverton HospitalRiverton, UT$31$28$8—$2$38

Look up this code directly

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