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
Helena, CA
See all hospitals reporting HCPCS J0650 →Price type
St Helena Hospital’s median price of $546 is 1458% above the median hospital's median price ($35), higher than 94% of the 1,647 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, 15 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 | Aetna aetna-all plans fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 2 | UnitedHealthcare uhc all payer - all other plans fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 3 | UnitedHealthcare uhc jll fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 4 | UnitedHealthcare uhc options ppo fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 5 | UnitedHealthcare uhc select/select plus fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 6 | Blue Cross Blue Shield blue cross exchange fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 7 | Blue Cross Blue Shield blue shield behav hlth percent of total billed charges · outpatientfrom % of charges | $405 | $405 | — | — | — | $405 – $405 |
| 8 | Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges | $418 | $418 | — | — | — | $418 – $418 |
| 9 | Blue Cross Blue Shield blue shield epn-all other plans percent of total billed charges · outpatientfrom % of charges | $424 | $424 | — | — | — | $424 – $424 |
| 10 | Phcs phcs-all plans percent of total billed charges · outpatientfrom % of charges | $495 | $495 | — | — | — | $495 – $495 |
| 11 | UnitedHealthcare umr uhc ppo percent of total billed charges · outpatientfrom % of charges | $573 | $573 | — | — | — | $573 – $573 |
| 12 | Blue Cross Blue Shield blue cross mcs - all other plans case rate · outpatient | $663 | $663 | — | — | — | $663 – $663 |
| 13 | Blue Cross Blue Shield blue cross non mcs case rate · outpatient | $663 | $663 | — | — | — | $663 – $663 |
| 14 | Cigna cigna-all other plans percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 15 | Kaiser kaiser-all other plans percent of total billed charges · outpatientfrom % of charges | $738 | $738 | — | — | — | $738 – $738 |
Last updated: Jul 15, 2026
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