go back

Texas rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Facilitymedian $91 · 10th–90th $50$1,2880%10%20%10th90th$91Professionalmedian $71 · 10th–90th $43$1150%20%10th90th$71$5.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $69.18 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $70.79 / $112.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $134.90
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $1,288.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $645.65
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $77.62 / $138.04
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $38.90
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $120.23 / $138.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $75.86 / $141.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $831.76 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $64.57 / $107.15
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $74.13 / $74.13