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
$5
Average
$3.6k
Median
$58
High
$21.0k
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 15 hospitals; the 90th percentile is 585.5× 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 | Bronson South Haven Hospital South Haven, MI | $60 | $60 | $18 | 30% | — | $42 – $79 |
| 3 | Bronson Battle Creek Hospital Battle Creek, MI | $60 | $60 | $14 | 23% | — | $42 – $79 |
| 4 | Hendrick Medical Center Abilene, TX | $13.7k | $16.0k | $7.9k | 50% | — | $5.9k – $29.0k |
| 5 | The University of Texas Medical Branch Galveston, TX | $37 | $42 | $24 | 58% | — | $18 – $94 |
| 6 | Hendrick Medical Center Brownwood, TX | $22.0k | $21.0k | $3.7k | 18% | — | $12.1k – $24.8k |
| 7 | MaineHealth Rockport, ME | $50 | $44 | $8 | 18% | — | $33 – $50 |
| 8 | Covenant Medical Center Inc Saginaw, MI | $48 | $55 | $14 | 25% | — | $39 – $78 |
| 9 | Bronson Methodist Hospital Kalamazoo, MI | $50 | $55 | $14 | 25% | — | $42 – $79 |
| 10 | Covenant Medical Center Inc Saginaw, MI | $48 | $55 | $14 | 25% | — | $39 – $78 |
Ask Claude or any MCP client for HCPCS A4261 pricing at a specific hospital — see how to connect.