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Diaphragm Or Cervical Cap Fitting And Insertion

Tennessee 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.

Rates data updated October 2026.

How much does Diaphragm Or Cervical Cap Fitting And Insertion cost?

$91.20

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $513 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$79.43$61.66 to $115
FacilityA hospital or hospital-owned outpatient department$513$151 to $1,096

How much rates vary

Facilitymedian $513 · 10th to 90th $52 to $1,738Professionalmedian $79 · 10th to 90th $47 to $550
$50$100$200$500$1K$2Kfacility $513professional $79

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$40.74
Median
$40.74
Typical High
$64.57
Aetna
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$63.10
Typical High
$91.20
BCBS Tennessee
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$724.44
Typical High
$1,862.09
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$77.62
Typical High
$141.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$52.48
Typical High
$162.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$70.79
Typical High
$134.90
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$549.54
Typical High
$630.96
United
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$436.52
Typical High
$1,778.28
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$77.62
Typical High
$138.04
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$20.42
Median
$31.62
Typical High
$45.71
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$8.13
Median
$12.59
Typical High
$18.20
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$6.17
Median
$9.55
Typical High
$13.49
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.07
Median
$6.31
Typical High
$9.12

Where Tennessee sits

The same service costs 3.1 times more in Wisconsin than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Tennessee· 14th of 51

$91.20

WI $204FL $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.