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Iowa rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $72.44 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $177.83 / $223.87
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $131.83 / $213.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $165.96 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $141.25 / $346.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $147.91 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $128.82 / $204.17
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $120.23 / $204.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,202.26 / $2,344.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $100.00 / $181.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $104.71 / $173.78