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Diaphragm Or Cervical Cap Fitting And Insertion

Georgia 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.

Facilitymedian $1,585 · 10th–90th $85$3,6310%10%10th90th$1,585Professionalmedian $76 · 10th–90th $46$1410%10%20%10th90th$76$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$85.11
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$70.79
Typical High
$131.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$2,398.83
Typical High
$4,168.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$97.72
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$91.20
Typical High
$162.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$74.13
Typical High
$134.90
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$117.49
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$1,318.26
Typical High
$2,344.23
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$81.28
Typical High
$144.54