go back

Diaphragm Or Cervical Cap Fitting And Insertion

Wisconsin 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 $2,818 · 10th–90th $158$5,6230%10%10th90th$2,818Professionalmedian $87 · 10th–90th $48$2240%5%10%10th90th$87$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
$50.12
Median
$95.50
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$70.79
Typical High
$158.49
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$3,090.30
Typical High
$5,754.40
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$131.83
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$239.88
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$138.04
Typical High
$269.15
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$154.88
Typical High
$3,801.89
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$208.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$512.86
Typical High
$1,778.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$141.25
Typical High
$346.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$891.25
Typical High
$2,344.23
Network Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$144.54
Typical High
$223.87
Quartz
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$141.25
Typical High
$239.88
Quartz
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$1,288.25
Typical High
$1,288.25
Quartz
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$190.55
Typical High
$549.54
Security Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$194.98
Security Health
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$251.19
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,584.89
Typical High
$2,187.76
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$100.00
Typical High
$251.19