HCPCS J0640
Injection, leucovorin calcium, per 50 mg
Current codeInjection - Monoclonal Antibodies39 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Cascade Valley Hospital | $4.09 – $9,386 | $38.51 – $348 | $48.14 – $435 |
| Deaconess Medical Center | $3.60 – $92.16 | $3.88 – $50.50 | $9.68 – $126 |
| EvergreenHealth Medical Center | $7.20 – $160 | $76.80 – $138 | $96.00 – $172 |
| Harborview Medical Center | $4.84 | — | — |
| Highline Medical Center | $14.45 – $1,410 | $10.26 – $478 | $33.60 – $1,567 |
| Island Hospital | $3.84 | — | — |
| Kadlec Regional Medical Center | $5.17 – $15.81 | $152 – $156 | $218 – $223 |
| Legacy Salmon Creek Medical Center | $5.07 – $7.90 | — | — |
| Mary Bridge Children's Hospital | $62.43 – $97.72 | $38.66 – $48.02 | $96.65 – $120 |
| MultiCare Auburn Medical Center | $57.52 | $31.52 | $78.80 |
| MultiCare Good Samaritan Hospital | $57.31 – $61.14 | $31.40 – $33.50 | $78.50 – $83.75 |
| Overlake Hospital Medical Center & Clinics | $7.74 – $8.24 | $2.08 – $83.18 | $4.15 – $166 |
| PeaceHealth Peace Island Medical Center | — | $159 – $355 | $245 – $546 |
| PeaceHealth Southwest Medical Cente | $5.95 | $159 – $355 | $245 – $546 |
| PeaceHealth St John Medical Center | $6.68 | $25.55 – $355 | $39.30 – $546 |
| PeaceHealth St Joseph Medical Center | $6.65 | $159 – $389 | $245 – $598 |
| PeaceHealth United General Medical Center | — | $159 – $522 | $245 – $803 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $5.17 – $9.16 | $101 – $532 | $144 – $759 |
| Providence Centralia Hospital | $11.54 – $25.72 | — | — |
| Providence Holy Family Hospital | $5.17 – $9.16 | $101 – $532 | $144 – $759 |
| Providence Regional Medical Center Everett | $5.17 – $9.16 | — | — |
| Providence St Mary Medical Center | $9.16 – $31.31 | $92.32 – $138 | $132 – $197 |
| Providence St Peter Hospital | $8.47 – $9.53 | $18.56 – $24.69 | $35.70 – $47.49 |
| Seattle Children's Hospital | $97.20 – $173 | $180 | $180 |
| Skagit Valley Hospital | $6.95 – $413 | $38.51 – $348 | $48.14 – $435 |
| St Anthony Hospital | $16.80 – $1,175 | $10.22 – $477 | $33.60 – $1,567 |
| St Clare Hospital | $16.80 – $1,175 | $9.69 – $452 | $33.60 – $1,567 |
| St Elizabeth Hospital | $5.19 – $1,410 | $11.88 – $554 | $33.60 – $1,567 |
| St Francis Community Hospital | $16.80 – $1,175 | $10.55 – $492 | $33.60 – $1,567 |
| St Joseph Medical Center | $16.80 – $1,175 | $11.13 – $519 | $33.60 – $1,567 |
| St Michael Medical Center | $6.82 – $1,410 | $14.83 – $691 | $33.60 – $1,567 |
| Swedish Edmonds Hospital | $5.17 – $8.47 | $164 | $341 |
| Swedish Issaquah | $5.17 – $8.47 | $164 | $341 |
| Swedish Medical Center | $5.17 – $8.47 | $164 | $341 |
| Swedish Medical Center / Cherry Hill | $5.17 – $8.47 | $164 | $341 |
| Tacoma General Allenmore Hospital | $6.36 – $62.82 | $3.49 – $34.42 | $8.71 – $86.05 |
| University of Washington Medical Ctr | $4.84 | — | — |
| Virginia Mason Medical Center | $4.94 – $24.20 | $4.20 – $15.43 | $8.24 – $30.25 |
| Yakima Valley Memorial | $8.13 – $75.24 | $6.64 – $35.12 | $16.60 – $87.80 |
Medicare (traditional) reference
CMS publishes no national amount for this code.