go back

Pennsylvania rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Facilitymedian $76 · 10th–90th $41$1,5490%20%10th90th$76Professionalmedian $68 · 10th–90th $42$1290%20%10th90th$68$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$40.74 / $40.74 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $66.07 / $128.82
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $79.43 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $77.62 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $125.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $97.72 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $70.79
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $67.61 / $120.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $138.04
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $112.20
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $67.61 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $616.60 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $72.44 / $117.49