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North Carolina rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $76.66 / $94.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.70 / $69.59 / $87.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.31 / $114.90 / $176.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.76 / $100.46 / $162.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $84.66 / $152.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.66 / $84.66 / $175.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $113.70 / $205.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.00 / $896.00 / $2,229.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.40 / $97.01 / $196.50
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $226.86 / $226.86
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.04 / $553.87 / $652.95