Contraceptive vaginal ring

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.

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Original text from hospital filings

Fee Schedule

Molina pricing summary

Low

$46

Average

$129

Median

$123

High

$223

Molina rate distribution

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46 hospital rates

#		Plans
1	AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient	1	$124	$124	—	—	—	$124 – $124
2	Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient	1	$78	$78	—	—	—	$78 – $78
3	Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient	1	$78	$78	—	—	—	$78 – $78
4	Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient	1	$163	$163	—	—	—	$163 – $163
5	CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT percent of total billed charges · inpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
6	CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT percent of total billed charges · outpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
7	CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT percent of total billed charges · inpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
8	CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT percent of total billed charges · outpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
9	CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT percent of total billed charges · inpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
10	CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT percent of total billed charges · outpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
11	CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT percent of total billed charges · inpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
12	CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT percent of total billed charges · outpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
13	CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT percent of total billed charges · inpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
14	CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT percent of total billed charges · outpatientfrom % of charges	1	$223	$223	—	—	—	$223 – $223
15	CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient	1	$121	$121	—	—	—	$121 – $121
16	CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient	1	$218	$218	—	—	—	$218 – $218
17	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient	1	$134	$134	—	—	—	$134 – $134
18	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient	1	$137	$137	—	—	—	$137 – $137
19	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient	1	$142	$142	—	—	—	$142 – $142
20	COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient	1	$167	$167	—	—	—	$167 – $167
21	Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient	1	$121	$121	—	—	—	$121 – $121
22	Fairview Hospital Cleveland, OH facility · case rate · outpatient	1	$128	$128	—	—	—	$128 – $128
23	Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient	1	$90	$90	—	—	—	$90 – $90
24	Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient	1	$105	$105	—	—	—	$105 – $105
25	Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient	1	$46	$46	—	—	—	$46 – $46

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← Payers reporting HCPCS J7303 · Snapshot 20261112T181611Z-3fa9fb76

HCPCS J7303