go back

Massachusetts rates for HCPCS 57170

Diaphragm/Cervical Cap Fitting W/Instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.47 / $48.47 / $62.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.47 / $67.02 / $124.73
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.76 / $393.05 / $2,733.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.91 / $127.11 / $553.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.58 / $69.65 / $122.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.26 / $116.95 / $245.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.04 / $118.59 / $218.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.53 / $128.41 / $210.49
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,078.00 / $3,445.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.94 / $177.34 / $553.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.00 / $1,818.00 / $2,733.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.97 / $122.38 / $231.37