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
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE
Low
$541
Average
$2.4k
Median
$2.0k
High
$6.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
57 payers; the 90th percentile is 3.6× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +26 other terms | 163 | $1.5k | $2.4k | $1.4k | 60% | 3–30 | $1 – $9.4k |
| 2 | UnitedHealthcare fee schedule · outpatient · +28 other terms | 424 | $2.5k | $2.4k | $1.3k | 55% | 1–10 | $1 – $12.2k |
| 3 | Cigna fee schedule · outpatient · +22 other terms | 224 | $2.3k | $3.4k | $2.5k | 73% | — | $9 – $10.6k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +25 other terms | 215 | $2.2k | $2.6k | $1.6k | 60% | — | $1 – $7.9k |
| 5 | Anthem facility · fee schedule · outpatient · +21 other terms | 54 | $1.3k | $1.9k | $940 | 50% | — | $360 – $5.8k |
| 6 | Humana fee schedule · outpatient · +22 other terms | 53 | $7.4k | $5.8k | $3.7k | 64% | — | $1 – $10.0k |
| 7 | Bcbs Tx fee schedule · outpatient · +3 other terms | 30 | $4.1k | $3.7k | $1.2k | 33% | — | $1.5k – $6.4k |
| 8 | Molina fee schedule · outpatient · +28 other terms | 30 | $1.2k | $1.0k | $509 | 49% | — | $1 – $2.3k |
| 9 | Caresource fee schedule · outpatient · +16 other terms | 24 | $1.3k | $1.3k | $198 | 16% | — | $1 – $1.4k |
| 10 | Aetna Better Health fee schedule · outpatient · +15 other terms | 21 | $1.2k | $1.2k | $185 | 16% | — | $649 – $1.4k |
| 11 | Tricare facility · fee schedule · outpatient · +12 other terms | 21 | $4.2k | $4.3k | $2.9k | 67% | — | $0 – $13.1k |
| 12 | Wellmark fee schedule · outpatient · +16 other terms | 20 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | Medica fee schedule · outpatient · +12 other terms | 19 | $1.9k | $2.0k | $958 | 48% | — | $2 – $3.0k |
| 14 | Medicaid facility · fee schedule · outpatient · +14 other terms | 19 | $1.2k | $1.1k | $303 | 27% | — | $288 – $1.5k |
| 15 | Highmark fee schedule · outpatient · +15 other terms | 18 | $1.4k | $1.2k | $452 | 38% | — | $9 – $1.6k |
| 16 | Premera fee schedule · outpatient · +12 other terms | 18 | $2.3k | $2.3k | $461 | 20% | — | $751 – $3.4k |
| 17 | Regence fee schedule · outpatient · +17 other terms | 17 | $1.9k | $2.1k | $1.2k | 58% | — | $751 – $5.1k |
| 18 | Beechstreet percent of total billed charges · outpatientfrom % of charges · +3 other terms | 15 | $4.4k | $4.2k | $804 | 19% | — | $2.3k – $5.5k |
| 19 | Bcbs La fee schedule · outpatient · +2 other terms | 13 | $1.2k | $1.2k | $81 | 7% | — | $1.1k – $1.3k |
| 20 | Optum facility · case rate · outpatient · +17 other terms | 13 | $595 | $618 | $203 | 33% | — | $273 – $1.0k |
| 21 | WellCare professional · fee schedule · both · +17 other terms | 13 | $386 | $512 | $815 | 159% | — | $0 – $2.6k |
| 22 | Bcbs Mn fee schedule · outpatient · +7 other terms | 12 | $1.1k | $1.1k | $335 | 30% | — | $564 – $1.4k |
| 23 | Bcbs Nj fee schedule · outpatient · +3 other terms | 12 | $1.2k | $1.2k | $24 | 2% | — | $1.2k – $1.2k |
| 24 | First Health professional · fee schedule · both · +19 other terms | 12 | $1.4k | $1.5k | $964 | 63% | — | $0 – $2.6k |
| 25 | Medcost fee schedule · both · +9 other terms | 12 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
← Hospitals reporting HCPCS J7296 · Snapshot 20261111T120946Z-9134e7f7