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 1.5 MG PO TAB
Low
$0
Average
$34
Median
$23
High
$176
Each hospital's average Humana rate, under the methodology and billing class chosen below.
47 hospitals; the 90th percentile is 73.8× 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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54 hospital rates
iThe hospitals that file a Humana 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 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 6 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · both | 2 | $2 | $2 | — | — | — | $2 – $2 |
| 7 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 2 | $121 | $137 | $143 | 104% | — | $8 – $766 |
| 8 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 2 | $121 | $137 | $143 | 104% | — | $8 – $766 |
| 9 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 10 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 11 | HCA FLORIDA OCALA HOSPITAL OCALA, FL percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | — | — | — | $9 – $9 |
| 12 | HCA FLORIDA WEST MARION HOSPITAL OCALA, FL percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | — | — | — | $9 – $9 |
| 13 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX percent of total billed charges · outpatientfrom % of charges | 2 | $35 | $35 | $29 | 82% | — | $6 – $64 |
| 14 | HCA HOUSTON HEALTHCARE KINGWOOD KINGWOOD, TX percent of total billed charges · outpatientfrom % of charges | 2 | $58 | $58 | $43 | 74% | — | $15 – $101 |
| 15 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 2 | $15 | $15 | — | — | — | $15 – $15 |
| 16 | HCA HOUSTON HEALTHCARE SOUTHEAST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 2 | $4 | $4 | — | — | — | $4 – $4 |
| 17 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | — | — | — | $16 – $16 |
| 18 | HCA HOUSTON HEALTHCARE WEST STAFFORD, TX percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | — | — | — | $88 – $88 |
| 19 | HCA Houston Rehabilitation Hospital Southeast Pasadena, TX percent of total billed charges · outpatientfrom % of charges | 2 | $4 | $4 | — | — | — | $4 – $4 |
| 20 | HEART HOSP OF AUSTIN Austin, TX percent of total billed charges · outpatientfrom % of charges | 2 | $53 | $53 | — | — | — | $53 – $53 |
| 21 | HEART HOSP OF AUSTIN AT ST. DAVID'S ROUND ROCK ROUND ROCK, TX percent of total billed charges · outpatientfrom % of charges | 2 | $53 | $53 | — | — | — | $53 – $53 |
| 22 | MEDICAL CITY MCKINNEY MCKINNEY, TX percent of total billed charges · outpatientfrom % of charges | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 23 | Methodist Medical Center of Illinois Peoria, IL fee schedule · inpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Methodist Medical Center of Illinois Peoria, IL fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Montefiore Medical Center Bronx, NY percent of total billed charges · bothfrom % of charges | 2 | $4 | $4 | — | — | — | $4 – $4 |
← Payers reporting HCPCS S4993 · Snapshot 20261111T120946Z-9134e7f7