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
$384
Average
$2.2k
Median
$1.8k
High
$7.6k
Each hospital's average Devoted rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 8.7× 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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25 hospital rates
iThe hospitals that file a Devoted 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 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 3 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $477 | $477 | — | — | — | $477 – $477 |
| 4 | HSA CGH LLC Coral Gables, FL facility · fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 5 | HSA PGH LLC Hialeah, FL facility · fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 6 | Knox Hospital Company LLC Knox, IN facility · fee schedule · outpatient | 1 | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 7 | La Porte Hospital Company LLC La Porte, IN facility · fee schedule · outpatient | 1 | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 8 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 9 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $384 | $384 | $148 | 38% | — | $237 – $532 |
| 10 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 11 | Missouri Baptist Sullivan Hospital Sullivan, MO percent of total billed charges · bothfrom % of charges | 1 | $733 | $733 | — | — | — | $733 – $733 |
| 12 | NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 13 | SAMARITAN NORTH LINCOLN HOSPITAL Lincoln City, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $477 | $477 | $183 | 38% | — | $294 – $660 |
| 14 | SAMARITAN PACIFIC HEALTH SERVICES INC Newport, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $437 | $437 | $168 | 38% | — | $269 – $605 |
| 15 | Samaritan Hospital Troy, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $7.6k | $7.6k | — | — | — | $7.6k – $7.6k |
| 16 | St Peters Hospital Albany, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $7.6k | $7.6k | — | — | — | $7.6k – $7.6k |
| 17 | St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | SwedishAmerican Hospital IL 61104; 1625 S State St Belvidere, IL percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 19 | The Chester County Hospital West Chester, PA facility · other · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 20 | The Toledo Hospital Maumee, OH facility · fee schedule · outpatient | 1 | $578 | $578 | — | — | — | $578 – $578 |
| 21 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · other · outpatient | 1 | $1.1k | $1.3k | $311 | 24% | — | $1.1k – $1.7k |
| 22 | USA Health Children's & Women's Hospital Mobile, AL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 23 | USA Health University Hospital Mobile, AL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 24 | University Hospitals Health System Geneva, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 25 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
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