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
Diaphragm or cervical cap fitting w/instructions 57170
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$280
Median
$42
High
$21.0k
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 234 hospitals; the 90th percentile is 7.1× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | USA Health University Hospital Mobile, AL | $64 | $64 | — | — | — | $64 – $64 |
| 2 | Fairview Health Services Edina, MN | $60 | $60 | $3 | 5% | — | $56 – $65 |
| 3 | Mayo Regional Hospital Dover Foxcroft, ME | $27 | $38 | $19 | 50% | — | $23 – $68 |
| 4 | Hoopeston Community Memorial Hospital Hoopeston, IL | $27 | $27 | — | — | — | $27 – $27 |
| 5 | William Beaumont Hospital Grosse Pointe, MI | $100 | $100 | — | — | — | $100 – $100 |
| 6 | Westfield Memorial Hospital Inc WESTFIELD, NY | $24 | $24 | $1 | 5% | — | $24 – $28 |
| 7 | Munson Healthcare Charlevoix Hospital Charlevoix, MI | $37 | $43 | $26 | 61% | — | $18 – $79 |
| 8 | Fairview Health Services Minneapolis, MN | $61 | $61 | $3 | 5% | — | $56 – $65 |
| 9 | Robert Wood Johnson University Hospital Somerset Somerville, NJ | $40 | $40 | — | — | — | $40 – $40 |
| 10 | Jefferson County Hospital OK Waurika, OK | $400 | $400 | — | — | — | $400 – $400 |
Ask Claude or any MCP client for HCPCS A4261 pricing at a specific hospital — see how to connect.