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New Jersey rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.91 / $69.73 / $96.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.61 / $62.58 / $87.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.68 / $87.58 / $185.84
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.29 / $117.53 / $143.63
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.09 / $868.04 / $993.28
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.56 / $68.73 / $118.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,529.00 / $3,352.00 / $10,536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $98.24 / $162.40