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
levothyroxine 100 mcg Solr 1 each VIAL
River Falls, WI
See all hospitals reporting HCPCS J0650 →Price type
Allina Health Systems’s median price of $115 is 229% above the median hospital's median price ($35), higher than 62% of the 1,652 hospitals reporting HCPCS J0650. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 17 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn bc pmap (r) facility · fee schedule · outpatient | $7 | $7 | — | — | — | $7 – $7 |
| 2 | Bcbs Mn bc premier (r) facility · fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 3 | Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 4 | Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 5 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $44 | $96 | $123 | 128% | — | $26 – $371 |
| 6 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $59 | $128 | $165 | 128% | — | $35 – $496 |
| 7 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $98 | $212 | $272 | 128% | — | $57 – $819 |
| 8 | Medica medica medicare (r) facility · fee schedule · outpatient | $98 | $212 | $272 | 128% | — | $57 – $819 |
| 9 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $99 | $215 | $276 | 128% | — | $58 – $830 |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $135 | $293 | $376 | 128% | — | $79 – $1.1k |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $136 | $296 | $379 | 128% | — | $79 – $1.1k |
| 12 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $146 | $316 | $406 | 128% | — | $85 – $1.2k |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $147 | $319 | $410 | 128% | — | $86 – $1.2k |
| 14 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $185 | $401 | $515 | 128% | — | $108 – $1.5k |
| 15 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $185 | $401 | $515 | 128% | — | $108 – $1.5k |
| 16 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $187 | $404 | $518 | 128% | — | $108 – $1.6k |
| 17 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $188 | $408 | $524 | 128% | — | $110 – $1.6k |
Last updated: Jun 15, 2026
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