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
LEVOLEUCOVORIN CALCIUM 10 MG/ML INTRAVENOUS SOLUTION
Ulysses, KS
See all hospitals reporting HCPCS J0641 →Price type
Commonspirit Kansas, Inc.’s median price of $2.0k is 1405407% above the median hospital's median price ($0), higher than 98% of the 1,259 hospitals reporting HCPCS J0641. 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, 13 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 Ks commercial ppo/hmo fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna managed medicare percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.2k | $717 | 60% | — | $240 – $2.0k |
| 3 | Humana managed medicare percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.2k | $717 | 60% | — | $240 – $2.0k |
| 4 | Medicare medicare percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.2k | $717 | 60% | — | $240 – $2.0k |
| 5 | UnitedHealthcare managed medicare percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.2k | $717 | 60% | — | $240 – $2.0k |
| 6 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $3.4k | $3.0k | $1.8k | 60% | — | $600 – $4.9k |
| 7 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $3.4k | $3.0k | $1.8k | 60% | — | $600 – $4.9k |
| 8 | UnitedHealthcare commercial ppo/pos/hmo/epo percent of total billed charges · inpatientfrom % of charges | $3.6k | $3.1k | $1.9k | 60% | — | $626 – $5.1k |
| 9 | UnitedHealthcare commercial ppo/pos/hmo/epo percent of total billed charges · outpatientfrom % of charges | $3.6k | $3.1k | $1.9k | 60% | — | $626 – $5.1k |
| 10 | MultiPlan commercial primary percent of total billed charges · inpatientfrom % of charges | $3.9k | $3.4k | $2.0k | 60% | — | $675 – $5.5k |
| 11 | MultiPlan commercial primary percent of total billed charges · outpatientfrom % of charges | $3.9k | $3.4k | $2.0k | 60% | — | $675 – $5.5k |
| 12 | MultiPlan commercial complementary percent of total billed charges · inpatientfrom % of charges | $4.0k | $3.5k | $2.1k | 60% | — | $698 – $5.7k |
| 13 | MultiPlan commercial complementary percent of total billed charges · outpatientfrom % of charges | $4.0k | $3.5k | $2.1k | 60% | — | $698 – $5.7k |
Last updated: Feb 3, 2026
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