HCPCS J7301

Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg

Current code39 hospitals with prices

Description from CMS's HCPCS Level II code file.

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.

Prices for HCPCS J7301 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Cascade Medical CenterLeavenworth$2,054 – $3,0874 plans$2,954$3,692
Cascade Valley HospitalArlington$1,7921 plan$1,433$1,792
EvergreenHealth Medical CenterKirkland—$2,632 – $4,073$3,290 – $5,091
Highline Medical CenterBurienFile dated 2026-02-28—$1,162 – $1,721$3,807 – $5,636
Island HospitalAnacortes$372 – $4033 plans$1,500$1,500
Olympic Medical CenterPort AngelesFile dated 2026-06-24$461 – $5055 plans$2,175$2,718
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$1,096$1,566
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$1,096$1,566
Seattle Children's HospitalSeattle$520 – $65812 plans$2,023$2,023
Skagit Valley HospitalMount Vernon—$1,433$1,792
St Anthony HospitalGig HarborFile dated 2026-02-28—$1,158 – $1,714$3,807 – $5,636
St Clare HospitalLakewoodFile dated 2026-02-28—$1,097 – $1,625$3,807 – $5,636
St Elizabeth HospitalEnumclawFile dated 2026-02-28$1,066 – $1,8695 plans$1,345 – $1,992$3,807 – $5,636
St Francis Community HospitalFederal WayFile dated 2026-02-28—$1,195 – $1,769$3,807 – $5,636
St Joseph Medical CenterTacomaFile dated 2026-02-28—$1,261 – $1,867$3,807 – $5,636
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$1,680 – $2,487$3,807 – $5,636
Three Rivers HospitalBrewster$1,1011 plan$1,573$1,573
Virginia Mason Medical CenterSeattle—$782$1,534

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.