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NDC 25021-0816-30

INJECTION, LEUCOVORIN CALCIUM, PER 50 MG

Reported by 3 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$210

Average

$472

Median

$307

High

$901

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.
1Mid Columbia Medical CenterDalles, OR$901$901$445—$211$1.3k
2Nebraska Medical CenterOmaha, NE$247$210$139—$4$761
3Bellevue Medical Center LlcBellevue, NE$254$307$132—$4$761

Look up this code directly

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