go back

Iowa rates for HCPCS 57170

Diaphragm/Cervical Cap Fitting W/Instructions

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.49 / $69.59 / $126.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.84 / $145.31 / $218.15
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.09 / $110.19 / $198.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.72 / $143.62 / $1,151.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.82 / $156.72 / $576.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.70 / $115.47 / $189.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.02 / $135.27 / $204.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $109.40 / $205.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,204.00 / $1,607.00 / $2,126.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.95 / $130.65 / $217.81
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.50 / $105.30 / $172.10