go back

Maine rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $70.79 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $81.28 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $93.33 / $138.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $89.13 / $141.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $70.79 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $85.11 / $141.25