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NDC 25021-0816-30

LEUCOVORIN CALCIUM 350 MG INJ SOLR

Reported by 43 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 4–40 billing samples across every hospital reporting.

Low

$32

Average

$222

Median

$242

High

$460

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.
1Winneshiek Medical CenterDecorah, IA$193$187$233–30$122$204
2DUKE UNIVERSITY HEALTH SYSTEM, INC. Doing Business As: DURHAM REGIONAL HOSPITALDurham, NC$35$51$281–10$6$142
3Northwestern Medicine Central DuPage HospitalWinfield, IL$170$164$107—$22$317
4Northwestern Memorial HospitalChicago, IL$139$154$94—$17$317
5Northwestern Medicine Kishwaukee HospitalDeKalb, IL$102$99$30—$25$139
6Northwestern Medicine Valley West HospitalSandwich, IL$89$76$47—$10$148
7Northwestern Medicine Delnor HospitalGeneva, IL$205$178$83—$44$298
8Palos Community HospitalPalos Heights, IL$56$49$24—$12$74
9Mid Columbia Medical CenterDalles, OR$380$333$79—$211$1.3k
10Saint Alphonsus Medical Center - Baker CityBaker City, OR$142$191$70—$25$316
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