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  4. /CPT J0650
CPT J0650

LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION at IHC Health Services Inc., DBA Intermountain Health LDS Hospital

Salt Lake City, UT

Pricing by billing methodology

Price type

All methodologies

$278

Aggregated across all available billing methodologies for this code.

Case rate

Not reported

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$10

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$282

Reflects a negotiated percentage of total billed charges.

Other

Not reported

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Aug 5, 2026

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See LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.

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