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Vermont rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $61.66 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $81.28 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $97.72 / $194.98