go back

New Hampshire rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Facilitymedian $257 · 10th–90th $178$1,5490%20%10th90th$257Professionalmedian $79 · 10th–90th $47$1510%10%10th90th$79$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $67.61 / $109.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $83.18 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $190.55
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $91.20 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $97.72 / $186.21