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HCPCS A4269

Contraceptive supply, spermicide (e.g., foam, gel), each

Current code11 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$1.01 – $3.402 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1.481 plan——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$1.99 – $4.402 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$4.111 plan——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$4.111 plan——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$4.111 plan——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1.21 – $1.482 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$1.631 plan——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$4.111 plan——
Virginia Mason Medical CenterSeattle$1.77 – $2.012 plans——
Yakima Valley MemorialYakimaFile dated 2026-08-27$1.013 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, 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.