go back

Diaphragm Or Cervical Cap Fitting And Insertion

Arizona rates for HCPCS 57170

This is the fitting and insertion of a diaphragm or cervical cap, barrier methods of birth control that are placed inside the vagina before intercourse to prevent pregnancy. A clinician determines the correct size, inserts the device to confirm proper fit, and provides instructions on how to use, insert, and remove it correctly. It's a one-time office visit for fitting, separate from any device purchased afterward.

Rates data updated October 2026.

How much does Diaphragm Or Cervical Cap Fitting And Insertion cost?

$69.18

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $69.18 for this service. The price depends on where it is billed: about $67.61 from a physician practice, and about $95.50 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$67.61$50.12 to $95.50
FacilityA hospital or hospital-owned outpatient department$95.50$37.15 to $407

How much rates vary

Facilitymedian $95 · 10th to 90th $11 to $1,445Professionalmedian $68 · 10th to 90th $43 to $347
$10$50$200$1Kfacility $95professional $68

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$61.66
Typical High
$69.18
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$8.13
Median
$19.05
Typical High
$50.12
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$85.11
Typical High
$158.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$36.31
Median
$47.86
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$69.18
Typical High
$104.71
Medica
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$316.23
Typical High
$1,584.89
Medica
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$346.74
Typical High
$575.44
United
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$524.81
Typical High
$2,238.72
United
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$63.10
Typical High
$109.65
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$20.42
Median
$30.20
Typical High
$33.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$8.32
Median
$12.02
Typical High
$13.49
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$6.17
Median
$9.12
Typical High
$10.00
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.17
Median
$6.03
Typical High
$6.76

Where Arizona sits

The same service costs 3.1 times more in Wisconsin than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 45th of 51

$69.18

WI $204FL $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.