Depo-estradiol injection, up to 5 mg

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

Depo-estradiol cypionate inj|TECHNICAL COMPONENT

Medicaid pricing summary

Low

Average

$139

Median

$101

High

$865

Medicaid rate distribution

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58 hospital rates

#		Plans
1	ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA fee schedule · outpatient	1	$28	$28	—	—	—	$28 – $28
2	ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient	1	$34	$34	$28	83%	—	$6 – $62
3	ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient	1	$62	$62	—	—	—	$62 – $62
4	Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient	2	$49	$49	—	—	—	$49 – $49
5	Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient	2	$7	$7	—	—	—	$7 – $7
6	Eisenhower Medical Center Rancho Mirage, CA fee schedule · both	3	$234	$234	—	—	—	$234 – $234
7	Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both	1	$50	$50	—	—	—	$50 – $50
8	Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges	1	$229	$229	—	—	—	$229 – $229
9	Hospital Authority of Colquitt County Moultrie, GA fee schedule · both	1	$22	$22	—	—	—	$22 – $22
10	Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient	1	$61	$61	—	—	—	$61 – $61
11	LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient	1	$62	$62	—	—	—	$62 – $62
12	Longview Medical Center LP Longview, TX facility · fee schedule · outpatient	1	$7	$7	—	—	—	$7 – $7
13	Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges	1	$865	$865	—	—	—	$865 – $865
14	Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient	1	$193	$193	—	—	—	$193 – $193
15	Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient	1	$193	$193	—	—	—	$193 – $193
16	Mercy Hospital Booneville Booneville, AR facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193
17	Mercy Hospital Cassville Knob, MO facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193
18	Mercy Hospital Cassville Knob, MO facility · percent of total billed charges · outpatientfrom % of charges	1	$240	$240	—	—	—	$240 – $240
19	Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193
20	Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges	1	$245	$245	—	—	—	$245 – $245
21	Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193
22	Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges	1	$245	$245	—	—	—	$245 – $245
23	Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges	2	$226	$226	$32	14%	—	$193 – $258
24	Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193
25	Mercy Hospital Ozark Ozark, AR facility · fee schedule · outpatient	2	$108	$108	$85	79%	—	$23 – $193

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HCPCS J1000