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Florida rates for HCPCS 57170

Diaphragm/Cervical Cap Fitting W/Instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.52 / $49.43 / $66.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.61 / $52.49 / $81.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.74 / $40.29 / $47.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.83 / $75.97 / $127.59
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,438.00 / $2,394.00 / $4,243.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.37 / $56.28 / $98.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.20 / $72.48 / $100.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.00 / $1,911.00 / $4,970.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.68 / $84.51 / $148.50
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.26 / $46.81 / $46.81