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-releasing intrauterine contraceptive system, 52 mg
Low
$770
Average
$1.3k
Median
$770
High
$5.9k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 2.9× 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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17 hospital rates
iThe hospitals that file a Anthem 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 | CHIPPENHAM HOSPITAL RICHMOND, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 2 | HENRICO DOCTORS HOSPITAL - FOREST MECHANICSVILLE, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 3 | JOHNSTON-WILLIS HOSPITAL RICHMOND, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 4 | LEWISGALE HOSPITAL ALLEGHANY LOW MOOR, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 5 | LEWISGALE HOSPITAL MONTGOMERY BLACKSBURG, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 6 | LEWISGALE HOSPITAL PULASKI PULASKI, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 7 | LEWISGALE MEDICAL CENTER ROANOKE, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 8 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 9 | PARHAM DOCTORS HOSPITAL Richmond, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 10 | RESTON HOSPITAL CENTER Reston, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 11 | RETREAT DOCTORS HOSPITAL RICHMOND, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 12 | SPOTSYLVANIA REGIONAL MEDICAL CENTER FREDERICKSBURG, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 13 | STONESPRINGS HOSPITAL CENTER Dulles, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 14 | TRICITIES HOSPITAL PRINCE GEORGE, VA case rate · outpatient | 1 | $770 | $770 | — | — | — | $770 – $770 |
| 15 | UCHealth Estes Valley Medical Center Estes Park, CO percent of total billed charges · inpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 16 | UCHealth Estes Valley Medical Center Estes Park, CO percent of total billed charges · outpatientfrom % of charges | 2 | $1.2k | $1.1k | $174 | 16% | — | $837 – $1.2k |
| 17 | UCLA West Valley Medical Center West Hills, CA fee schedule · outpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
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