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HCPCS J0640

Injection, leucovorin calcium, per 50 mg

Current codeInjection - Monoclonal Antibodies39 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Cascade Valley HospitalArlington$4.09 – $9,3868 plans$38.51 – $348$48.14 – $435
Deaconess Medical CenterSpokaneFile dated 2026-08-27$6.88 – $92.162 plans$3.88 – $50.50$9.68 – $126
EvergreenHealth Medical CenterKirkland$7.20 – $1607 plans$76.80 – $138$96.00 – $172
Highline Medical CenterBurienFile dated 2026-02-28$14.45 – $1,4106 plans$10.26 – $478$33.60 – $1,567
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$152 – $156$218 – $223
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$63.21 – $96.046 plans$38.66 – $48.02$96.65 – $120
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$46.49 – $57.523 plans$31.52$78.80
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$46.32 – $61.143 plans$31.40 – $33.50$78.50 – $83.75
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01—$2.08 – $83.18$4.15 – $166
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$101 – $532$144 – $759
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$101 – $532$144 – $759
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$92.32 – $138$132 – $197
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$18.56 – $24.69$35.70 – $47.49
Seattle Children's HospitalSeattle$97.20 – $17398 plans$180$180
Skagit Valley HospitalMount Vernon$6.95 – $4137 plans$38.51 – $348$48.14 – $435
St Anthony HospitalGig HarborFile dated 2026-02-28$18.48 – $1,1754 plans$10.22 – $477$33.60 – $1,567
St Clare HospitalLakewoodFile dated 2026-02-28$18.48 – $1,1754 plans$9.69 – $452$33.60 – $1,567
St Elizabeth HospitalEnumclawFile dated 2026-02-28$12.10 – $1,4109 plans$11.88 – $554$33.60 – $1,567
St Francis Community HospitalFederal WayFile dated 2026-02-28$18.48 – $1,1754 plans$10.55 – $492$33.60 – $1,567
St Joseph Medical CenterTacomaFile dated 2026-02-28$18.48 – $1,1754 plans$11.13 – $519$33.60 – $1,567
St Michael Medical CenterSilverdaleFile dated 2026-02-28$21.17 – $1,41010 plans$14.83 – $691$33.60 – $1,567
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$164$341
Swedish IssaquahIssaquahFile dated 2026-04-01—$164$341
Swedish Medical CenterSeattleFile dated 2026-04-01—$164$341
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$164$341
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$5.14 – $62.823 plans$3.49 – $34.42$8.71 – $86.05
Virginia Mason Medical CenterSeattle$5.28 – $24.204 plans$4.20 – $15.43$8.24 – $30.25
Yakima Valley MemorialYakimaFile dated 2026-08-27$9.30 – $49.171 plan$6.64 – $35.12$16.60 – $87.80

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.