Levothyroxine sodium injection, 10 mcg at Wayne Memorial Hospital

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION

Goldsboro, NC

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Pricing by billing methodology

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How this price compares nationally

Wayne Memorial Hospital’s median price of $82 is 652% above the median hospital's median price ($11), higher than 75% of the 1,464 hospitals reporting HCPCS J0651. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0651 at Wayne Memorial Hospital

Negotiated rates from the hospital’s own file: 9 payers, 21 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	Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
2	Optum vaccn facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
3	Humana medicare hmo facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
4	Humana medicare ppo facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
5	Cigna medicare advantage facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
6	UnitedHealthcare medicare advantage facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
7	Aetna medicare advantage facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
8	Cigna commercial facility · fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
9	UnitedHealthcare commercial facility · fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
10	UnitedHealthcare individual exchange facility · fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
11	Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$82	$82	—	—	—	$82 – $82
12	UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges	$82	$82	—	—	—	$82 – $82
13	WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$82	$82	—	—	—	$82 – $82
14	Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges	$157	$157	—	—	—	$157 – $157
15	Aetna north carolina preferred facility · percent of total billed charges · outpatientfrom % of charges	$237	$237	—	—	—	$237 – $237
16	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$246	$246	—	—	—	$246 – $246
17	UnitedHealthcare individual exchange facility · percent of total billed charges · inpatientfrom % of charges	$246	$246	—	—	—	$246 – $246
18	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$259	$259	—	—	—	$259 – $259
19	Medcost commercial/ultra facility · percent of total billed charges · outpatientfrom % of charges	$271	$271	—	—	—	$271 – $271
20	Medcost commercial/ultra facility · percent of total billed charges · inpatientfrom % of charges	$274	$274	—	—	—	$274 – $274
21	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$287	$287	—	—	—	$287 – $287

Last updated: Jun 18, 2026

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