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Diaphragm Or Cervical Cap Fitting And Insertion

South Carolina rates for HCPCS 57170

This is the fitting and insertion of a diaphragm or cervical cap, barrier methods of birth control that are placed inside the vagina before intercourse to prevent pregnancy. A clinician determines the correct size, inserts the device to confirm proper fit, and provides instructions on how to use, insert, and remove it correctly. It's a one-time office visit for fitting, separate from any device purchased afterward.

Facilitymedian $72 · 10th–90th $25$7590%5%10%10th90th$72Professionalmedian $68 · 10th–90th $43$1170%10%10th90th$68$20.0$100.0$500.0$2.0K

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
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$85.11
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$66.07
Typical High
$117.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$33.11
Typical High
$60.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$69.18
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$81.28
Typical High
$131.83
Medcost
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$81.28
Typical High
$147.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,122.02
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$70.79
Typical High
$131.83