NDC 42023-0202-01
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.
Original text from hospital filings
INJECTION, LEVOTHYROXINE SODIUM, NOT OTHERWISE SPECIFIED, 10 MCG
Reported by 6 hospitals in the network under the case rate methodology.
Based on 110 billing samples across every hospital reporting.
Low
$10
Average
$540
Median
$761
High
$761
Filter by billing methodology
Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
Showing only prices reported under the case rate methodology. Choose another in the filter above to change the chart. 6 hospitals; the 90th percentile is 7.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | Location | Approximate 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. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Boston Children's Hospital | Boston, MA | $10 | $10 | — | 110 | $6 | $589 |
| 2 | White Memorial Medical Center | Angeles, CA | $186 | $186 | — | — | $24 | $1.4k |
| 3 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania | Philadelphia, PA | $761 | $761 | — | — | $129 | $761 |
| 4 | Pennsylvania Hospital of the University of Pennsylvania Health System | Philadelphia, PA | $761 | $761 | — | — | $129 | $761 |
| 5 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center | Philadelphia, PA | $761 | $761 | — | — | $129 | $761 |
| 6 | The Chester County Hospital | West Chester, PA | $761 | $761 | — | — | $175 | $761 |
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