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.
Generation details were not recorded for this description.
Original text from hospital filings
Spermicide
Low
$1
Average
$3
Median
$1
High
$71
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 2.8× 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.
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55 hospital rates
iThe hospitals that file a Cigna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 2 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 3 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 6 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 7 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $1 | $1 | $0 | 4% | — | $1 – $1 |
| 11 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $1 | $1 | $0 | 9% | — | $1 – $1 |
| 14 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 1 | $2 | $2 | $0 | 9% | — | $2 – $2 |
| 15 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 17 | HOLY ROSARY HEALTHCARE DBA INTERMOUNTAIN HEALTH HOLY ROSARY HOSPITAL CITY, MT professional · fee schedule · outpatient | 4 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · fee schedule · outpatient | 3 | $1 | $1 | $0 | 10% | — | $1 – $1 |
| 19 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · fee schedule · outpatient | 3 | $1 | $1 | $0 | 23% | — | $1 – $1 |
| 20 | Maine Coast Regional Health Facilities Ellsworth, ME facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 21 | Maine Coast Regional Health Facilities Ellsworth, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 22 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Mayo Regional Hospital Dover Foxcroft, ME facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Mayo Regional Hospital Dover Foxcroft, ME professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Memorial Hospital of Laramie County Cheyenne, WY fee schedule · both | 1 | $1 | $1 | — | — | — | $1 – $1 |
← Payers reporting HCPCS A4269 · Snapshot 20261111T120946Z-9134e7f7