HCPCS J7301
Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
Current code39 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Cascade Medical Center | $1,972 | $2,954 | $3,692 |
| Cascade Valley Hospital | — | $1,433 | $1,792 |
| EvergreenHealth Medical Center | — | $2,632 – $4,073 | $3,290 – $5,091 |
| Highline Medical Center | — | $1,162 – $1,721 | $3,807 – $5,636 |
| Island Hospital | — | $1,500 | $1,500 |
| Olympic Medical Center | — | $2,175 | $2,718 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $1,096 | $1,566 |
| Providence Holy Family Hospital | — | $1,096 | $1,566 |
| Seattle Children's Hospital | $510 | $2,023 | $2,023 |
| Skagit Valley Hospital | — | $1,433 | $1,792 |
| St Anthony Hospital | — | $1,158 – $1,714 | $3,807 – $5,636 |
| St Clare Hospital | — | $1,097 – $1,625 | $3,807 – $5,636 |
| St Elizabeth Hospital | — | $1,345 – $1,992 | $3,807 – $5,636 |
| St Francis Community Hospital | — | $1,195 – $1,769 | $3,807 – $5,636 |
| St Joseph Medical Center | — | $1,261 – $1,867 | $3,807 – $5,636 |
| St Michael Medical Center | — | $1,680 – $2,487 | $3,807 – $5,636 |
| Three Rivers Hospital | $1,101 | $1,573 | $1,573 |
| Virginia Mason Medical Center | — | $782 | $1,534 |
Medicare (traditional) reference
CMS publishes no national amount for this code.