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
$0
Average
$2.5k
Median
$2.1k
High
$12.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
738 hospitals; the 90th percentile is 4.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
1,156 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | St. Lukes Hospital of Kansas City City, KS percent of total billed charges · bothfrom % of charges | 11 | $2.4k | $2.1k | $720 | 34% | 5–50 | $963 – $3.5k |
| 2 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $2.8k | $2.9k | $378 | 13% | 4–40 | $2.4k – $3.4k |
| 3 | Mon Health Medical Center Morgantown, WV fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | 3–30 | $1.4k – $1.4k |
| 4 | Duke University Hospital Durham, NC facility · percent of total billed charges · outpatientfrom % of charges | 4 | $2.4k | $2.7k | $1.0k | 38% | 2–20 | $1.8k – $4.4k |
| 5 | Duke University Hospital Raleigh, NC facility · percent of total billed charges · outpatientfrom % of charges | 4 | $2.4k | $2.7k | $1.0k | 38% | 2–20 | $1.8k – $4.4k |
| 6 | HCA HEALTHONE CENTRAL PARK ER DENVER, CO percent of total billed charges · outpatientfrom % of charges | 3 | $2.2k | $2.2k | $198 | 9% | 2–20 | $2.0k – $2.4k |
| 7 | HCA HEALTHONE ROSE Denver, CO percent of total billed charges · outpatientfrom % of charges | 3 | $2.2k | $2.2k | $198 | 9% | 2–20 | $2.0k – $2.4k |
| 8 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 2–20 | $4.9k – $4.9k |
| 9 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 2–20 | $4.9k – $4.9k |
| 10 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $2.1k | $2.1k | — | — | 1–10 | $2.1k – $2.1k |
| 11 | City Hospital, Inc. Martinsburg, WV facility · other · outpatient | 1 | $1.0k | $1.0k | — | — | 1–10 | $1.0k – $1.0k |
| 12 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 1–10 | $4.9k – $4.9k |
| 13 | Community Health Association Ripley, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.0k | $1.0k | — | — | 1–10 | $1.0k – $1.0k |
| 14 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · other · outpatient | 1 | $1.0k | $1.0k | — | — | 1–10 | $1.0k – $1.0k |
| 15 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 1–10 | $4.9k – $4.9k |
| 16 | Martha's Vineyard Hospital Bluffs, MA percent of total billed charges · bothfrom % of charges | 1 | $2.4k | $2.4k | — | — | 1–10 | $2.4k – $2.4k |
| 17 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $3.0k | $3.0k | — | — | 1–10 | $3.0k – $3.0k |
| 18 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 3 | $1.6k | $1.6k | — | — | 1–10 | $1.6k – $1.6k |
| 19 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 4 | $1.4k | $1.4k | $132 | 9% | 1–10 | $1.3k – $1.6k |
| 20 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 1 | $1.6k | $1.6k | — | — | 1–10 | $1.6k – $1.6k |
| 21 | NYU Langone Mineola, NY percent of total billed charges · outpatientfrom % of charges | 25 | $9.2k | $9.4k | $1.2k | 13% | 1–10 | $9.2k – $15.3k |
| 22 | NYU Langone New York, NY percent of total billed charges · outpatientfrom % of charges | 25 | $9.2k | $9.4k | $1.2k | 13% | 1–10 | $9.2k – $15.3k |
| 23 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 3 | $2.4k | $2.3k | $94 | 4% | 1–10 | $2.2k – $2.4k |
| 24 | St. Francis Hospital Inc Wilmington, DE professional · fee schedule · both | 1 | $5.5k | $5.5k | — | — | 1–10 | $5.5k – $5.5k |
| 25 | Sturdy Memorial Hospital Attleboro, MA percent of total billed charges · outpatientfrom % of charges | 1 | $2.7k | $2.7k | — | — | 1–10 | $2.7k – $2.7k |
← Payers reporting HCPCS J7296 · Snapshot 20261111T120946Z-9134e7f7