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
$2.3k
High
$28.5k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
985 hospitals; the 90th percentile is 3.6× 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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1,440 hospital rates
iThe hospitals that file a UnitedHealthcare 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 other · both | 13 | $2.4k | $2.3k | $224 | 10% | 22–85 | $1.6k – $2.4k |
| 2 | SONORA COMMUNITY HOSPITAL Sonora, CA percent of total billed charges · outpatientfrom % of charges | 4 | $2.6k | $2.9k | $809 | 28% | 8–80 | $2.3k – $4.8k |
| 3 | Mon Health Medical Center Morgantown, WV percent of total billed charges · outpatientfrom % of charges | 1 | $3.2k | $5.4k | $3.4k | 62% | 3–30 | $3.0k – $10.6k |
| 4 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $3.2k | $2.5k | $922 | 37% | 2–20 | $1.2k – $3.2k |
| 5 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 3 | $1.5k | $1.3k | $439 | 33% | 2–20 | $349 – $1.5k |
| 6 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $1.4k | $1.4k | — | — | 2–20 | $1.4k – $1.4k |
| 7 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 4 | $2.4k | $2.4k | $50 | 2% | 2–20 | $2.3k – $2.4k |
| 8 | Barnes Jewish Hospital St. Louis, MO fee schedule · both | 1 | $2.5k | $2.5k | — | — | 1–10 | $2.5k – $2.5k |
| 9 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | 1–10 | $1.7k – $1.7k |
| 10 | Indiana University Health Bloomington Inc. Bloomington, IN fee schedule · outpatient | 2 | $1.3k | $1.1k | $242 | 21% | 1–10 | $716 – $1.3k |
| 11 | MCLAREN MACOMB CLEMENS, MI percent of total billed chargesfrom % of charges | 1 | $2.3k | $2.3k | — | — | 1–10 | $2.3k – $2.3k |
| 12 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $1.5k | $1.3k | $402 | 30% | 1–10 | $536 – $1.5k |
| 13 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $1.5k | $1.3k | $399 | 30% | 1–10 | $546 – $1.5k |
| 14 | Missouri Baptist Medical Center Saint Louis, MO fee schedule · both | 1 | $2.5k | $2.5k | — | — | 1–10 | $2.5k – $2.5k |
| 15 | Novant Health Ballantyne Medical Center LLC Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $940 | $940 | — | — | 1–10 | $940 – $940 |
| 16 | St Luke's Regional Medical Center, LTD Mountain Home, ID percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.7k | $504 | 29% | 1–10 | $1.2k – $2.3k |
| 17 | St. Francis Hospital Inc Wilmington, DE professional · fee schedule · both | 1 | $2.6k | $2.6k | — | — | 1–10 | $2.6k – $2.6k |
| 18 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO other · outpatient | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 19 | Tufts Medical Center BOSTON, MA other · both | 1 | $3.5k | $3.5k | — | — | 1–10 | $3.5k – $3.5k |
| 20 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 3 | $3.3k | $3.6k | $633 | 18% | 1–10 | $3.0k – $4.5k |
| 21 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 22 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA fee schedule · outpatient | 2 | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 23 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $568 | $568 | — | — | — | $568 – $568 |
| 24 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 2 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 25 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 2 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
← Payers reporting HCPCS J7296 · Snapshot 20261111T120946Z-9134e7f7