HCPCS J7297
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg
Current code35 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $394 – $584 | $544 | $1,360 |
| Cascade Valley Hospital | $389 – $1,599 | $1,278 | $1,597 |
| Deaconess Medical Center | $360 – $382 | $670 | $1,676 |
| Highline Medical Center | — | $1,610 | $5,272 |
| Island Hospital | $372 – $403 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | $373 – $403 | $544 | $1,360 |
| MultiCare Auburn Medical Center | $366 – $395 | $544 | $1,360 |
| MultiCare Covington Medical Center | $366 – $395 | $544 | $1,360 |
| MultiCare Good Samaritan Hospital | $375 – $404 | $544 | $1,360 |
| MultiCare Valley Hospital | $358 – $379 | — | — |
| Olympic Medical Center | $461 – $505 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | $1,858 | $2,654 |
| Providence St Peter Hospital | — | — | — |
| Seattle Children's Hospital | $479 – $606 | $1,864 | $1,864 |
| Skagit Valley Hospital | $361 – $477 | $985 – $1,278 | $1,231 – $1,597 |
| St Anthony Hospital | — | $1,603 | $5,272 |
| St Clare Hospital | — | $1,520 | $5,272 |
| St Elizabeth Hospital | $896 – $1,091 | $1,863 | $5,272 |
| St Francis Community Hospital | — | $1,654 | $5,272 |
| St Joseph Medical Center | — | $1,746 | $5,272 |
| St Michael Medical Center | — | $2,327 | $5,272 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | $375 – $405 | $544 | $1,360 |
| Virginia Mason Medical Center | — | $785 | $1,539 |
| Yakima Valley Memorial | $358 – $416 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.