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
$1
Average
$2.9k
Median
$2.4k
High
$13.3k
Each hospital's average Premera rate, under the methodology and billing class chosen below.
38 hospitals; the 90th percentile is 2.6× 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.
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41 hospital rates
iThe hospitals that file a Premera 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 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $3.4k | $3.3k | $123 | 4% | 1–10 | $3.1k – $3.4k |
| 2 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 3 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 4 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $3.2k | $3.2k | $0 | 0% | — | $3.2k – $3.2k |
| 5 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 6 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 2 | $1.9k | $1.8k | $840 | 46% | — | $751 – $2.6k |
| 7 | FRANCISCAN HEALTH SYSTEM Gig Harbor, WA fee schedule · outpatient | 2 | $2.3k | $2.3k | $385 | 17% | — | $1.9k – $2.6k |
| 8 | FRANCISCAN HEALTH SYSTEM Tacoma, WA fee schedule · outpatient | 2 | $2.3k | $2.3k | $385 | 17% | — | $1.9k – $2.6k |
| 9 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $2.4k | $2.4k | $319 | 13% | — | $2.0k – $2.9k |
| 10 | HARRISON MEDICAL CENTER Silverdale, WA fee schedule · outpatient | 2 | $2.8k | $2.8k | $522 | 18% | — | $2.3k – $3.4k |
| 11 | HIGHLINE MEDICAL CENTER Burien, WA fee schedule · outpatient | 2 | $2.2k | $2.2k | $114 | 5% | — | $2.1k – $2.3k |
| 12 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $13.3k | $13.3k | — | — | — | $13.3k – $13.3k |
| 13 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 4 | $2.4k | $2.4k | $319 | 13% | — | $2.0k – $2.9k |
| 14 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 15 | Mercy Medical Center-Clinton Inc Clinton, IA professional · fee schedule · both | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 16 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $2.4k | $2.4k | $319 | 13% | — | $2.0k – $2.9k |
| 17 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $2.4k | $2.3k | $187 | 8% | — | $2.0k – $2.4k |
| 18 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $2.4k | $2.4k | $319 | 13% | — | $2.0k – $2.9k |
| 19 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 4 | $1.7k | $1.7k | $157 | 9% | — | $1.7k – $2.0k |
| 20 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 4 | $1.7k | $1.7k | $157 | 9% | — | $1.7k – $2.0k |
| 21 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 3 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 22 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 23 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 24 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · outpatient | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 25 | Public Hospital Dist No 1 Skagit dba Cascade Valley Hospital Arlington, WA fee schedule · both | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
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