Levonorgestrel intrauterine system insert

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Insert levonorgestrel ius

Payers reporting HCPCS S4981

Payer pricing summary

Low

Average

$4.3k

Median

$388

High

$50k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	89	$8.0k	$12.7k	$8.9k	70%	—	$0 – $36.7k
2	Aetna case rate · outpatient · +7 other terms	52	$4.0k	$5.1k	$2.2k	43%	—	$319 – $13.5k
3	Bcbs Tx fee schedule · outpatient · +1 other terms	31	$1.7k	$1.7k	$713	41%	—	$843 – $4.5k
4	Molina facility · case rate · outpatient · +5 other terms	29	$105	$122	$61	50%	—	$44 – $311
5	Humana other · outpatient · +7 other terms	25	$2.9k	$2.9k	$861	29%	—	$2.3k – $7.0k
6	UnitedHealthcare facility · case rate · outpatient · +7 other terms	18	$67	$88	$40	46%	—	$44 – $188
7	Anthem facility · case rate · outpatient · +7 other terms	15	$62	$68	$16	23%	—	$42 – $105
8	Caresource facility · case rate · outpatient · +3 other terms	15	$63	$68	$16	23%	—	$42 – $107
9	Cigna facility · fee schedule · outpatient · +5 other terms	13	$20	$51	$110	216%	—	$20 – $528
10	Optum facility · case rate · outpatient · +1 other terms	13	$60	$75	$28	37%	—	$53 – $132
11	Wellmark fee schedule · both · +3 other terms	13	$364	$369	$32	9%	—	$364 – $567
12	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1.0k	$704	$530	75%	—	$117 – $1.3k
13	Highmark fee schedule · outpatient · +3 other terms	11	$95	$99	$33	33%	—	$86 – $419
14	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$38	$38	—	—	—	$38 – $38
15	Amerihealth Caritas facility · case rate · outpatient · +2 other terms	7	$153	$155	$5	3%	—	$153 – $167
16	Phcs percent of total billed charges · outpatientfrom % of charges	5	$37.5k	$37.5k	—	—	—	$37.5k – $37.5k
17	Tricare fee schedule · outpatient	5	$50k	$50k	—	—	—	$50k – $50k
18	First Health professional · fee schedule · both · +1 other terms	3	$51	$51	$10	20%	—	$40 – $61
19	Medicaid facility · case rate · outpatient · +1 other terms	2	$139	$139	—	—	—	$139 – $139
20	MultiPlan percent of total billed charges · bothfrom % of charges · +1 other terms	2	$695	$695	$520	75%	—	$175 – $1.2k
21	Bcbs Il professional · fee schedule · both	1	$567	$567	—	—	—	$567 – $567
22	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
23	Bcbs Nc facility · fee schedule · outpatient	1	$118	$118	$14	12%	—	$108 – $138
24	Bcbs Nv fee schedule · outpatient	1	$93	$93	$36	38%	—	$57 – $128
25	Bcbs Vt professional · fee schedule · outpatient	1	$37	$37	—	—	—	$37 – $37

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