go back

Minnesota rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $72.44 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $67.61 / $102.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $501.19 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $141.25 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $288.40 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $190.55 / $323.59
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $275.42 / $537.03
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $169.82 / $302.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $123.03 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $154.88 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,862.09 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $117.49 / $251.19