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
$2
Average
$125
Median
$93
High
$407
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
87 hospitals; the 90th percentile is 41.4× 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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104 hospital rates
iThe hospitals that file a MultiPlan 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 | ALASKA REGIONAL HOSPITAL Anchorage, AK percent of total billed charges · outpatientfrom % of charges | 3 | $119 | $116 | $4 | 3% | — | $111 – $119 |
| 2 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 3 | BLUE RIDGE REGIONAL HOSPITAL Spruce Pine, NC percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 4 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 5 | Bexar County Hospital District San Antonio, TX percent of total billed charges · inpatientfrom % of charges | 2 | $20 | $39 | $44 | 114% | — | $5 – $138 |
| 6 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 2 | $20 | $39 | $44 | 114% | — | $5 – $138 |
| 7 | CAREPARTNERS REHABILITATION HOSPITAL Asheville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $101 | $86 | 85% | — | $11 – $217 |
| 8 | CHIPPENHAM HOSPITAL RICHMOND, VA percent of total billed charges · outpatientfrom % of charges | 1 | $96 | $91 | $10 | 11% | — | $77 – $100 |
| 9 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 10 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 11 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 1 | $169 | $180 | $187 | 104% | — | $11 – $941 |
| 12 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $169 | $180 | $187 | 104% | — | $11 – $941 |
| 13 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 14 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 15 | DOMINION HOSPITAL FALLS CHURCH, VA percent of total billed charges · outpatientfrom % of charges | 1 | $101 | $121 | $85 | 71% | — | $12 – $278 |
| 16 | HCA FLORIDA FORT WALTON-DESTIN HOSPITAL FT WALTON BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $23 | $23 | $1 | 4% | — | $22 – $24 |
| 17 | HCA FLORIDA JFK NORTH HOSPITAL West Palm Beach, FL percent of total billed charges · outpatientfrom % of charges | 2 | $10 | $10 | $9 | 85% | — | $2 – $20 |
| 18 | HCA FLORIDA KENDALL HOSPITAL MIAMI, FL percent of total billed charges · outpatientfrom % of charges | 2 | $116 | $116 | $7 | 6% | — | $109 – $123 |
| 19 | HCA FLORIDA LAKE CITY HOSPITAL LAKE CITY, FL percent of total billed charges · outpatientfrom % of charges | 2 | $32 | $32 | $1 | 4% | — | $30 – $33 |
| 20 | HCA FLORIDA LAWNWOOD HOSPITAL VERO BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $7 | $7 | $0 | 6% | — | $7 – $8 |
| 21 | HCA FLORIDA NORTH FLORIDA HOSPITAL GAINESVILLE, FL percent of total billed charges · outpatientfrom % of charges | 2 | $7 | $7 | $4 | 51% | — | $4 – $12 |
| 22 | HCA FLORIDA OCALA HOSPITAL OCALA, FL percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 23 | HCA FLORIDA ORANGE PARK HOSPITAL ORANGE PARK, FL percent of total billed charges · outpatientfrom % of charges | 2 | $10 | $10 | $0 | 4% | — | $9 – $10 |
| 24 | HCA FLORIDA PALMS WEST HOSPITAL LOXAHATCHEE, FL percent of total billed charges · outpatientfrom % of charges | 2 | $18 | $18 | $1 | 6% | — | $17 – $19 |
| 25 | HCA FLORIDA WEST HOSPITAL PENSACOLA, FL percent of total billed charges · outpatientfrom % of charges | 2 | $39 | $39 | $2 | 4% | — | $37 – $40 |
← Payers reporting HCPCS S4993 · Snapshot 20261111T120946Z-9134e7f7