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
$2.1k
Median
$1.6k
High
$7.6k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
50 hospitals; the 90th percentile is 3.7× 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.
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62 hospital rates
iThe hospitals that file a Ambetter 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 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 2 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 3 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 4 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 5 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 6 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 7 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 8 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 2 | $1.7k | $1.7k | $106 | 6% | — | $1.6k – $1.8k |
| 9 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · inpatientfrom % of charges | 2 | $1.7k | $1.7k | $90 | 5% | — | $1.6k – $1.8k |
| 10 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 2 | $1.7k | $1.7k | $109 | 6% | — | $1.6k – $1.8k |
| 11 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · inpatientfrom % of charges | 2 | $1.7k | $1.7k | $128 | 8% | — | $1.6k – $1.8k |
| 12 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 2 | $1.6k | $1.6k | $161 | 10% | — | $1.5k – $1.8k |
| 13 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $1.6k | $1.6k | $176 | 11% | — | $1.4k – $1.8k |
| 14 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 2 | $2.2k | $2.2k | $114 | 5% | — | $2.1k – $2.3k |
| 15 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $2.1k | $2.1k | $175 | 8% | — | $1.9k – $2.3k |
| 16 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $1.6k | $1.6k | $176 | 11% | — | $1.4k – $1.8k |
| 17 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 18 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 2 | $2.2k | $2.2k | $61 | 3% | — | $2.2k – $2.3k |
| 19 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 2 | $2.2k | $2.2k | $61 | 3% | — | $2.2k – $2.3k |
| 20 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Eisenhower Medical Center Rancho Mirage, CA percent of total billed charges · bothfrom % of charges | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 25 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
← Payers reporting HCPCS J7296 · Snapshot 20261111T120946Z-9134e7f7