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Washington rates for HCPCS 57170

Diaphragm or cervical cap fitting with instructions

Facilitymedian $117 · 10th–90th $68$4470%10%20%10th90th$117Professionalmedian $87 · 10th–90th $48$1780%10%10th90th$87$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
$87.10 / $117.49 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $70.79 / $165.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $524.81 / $1,071.52
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $120.23 / $218.78
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $199.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $151.36
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $194.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $549.54 / $1,071.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $707.95 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $95.50 / $181.97
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $81.28 / $104.71