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Missouri rates for HCPCS 57170

Diaphragm/Cervical Cap Fitting W/Instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.72 / $57.46 / $76.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.72 / $60.12 / $270.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.06 / $74.84 / $118.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.14 / $89.75 / $164.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.60 / $92.95 / $747.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.26 / $128.03 / $576.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $760.00 / $1,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.40 / $94.77 / $215.24