Contraceptive diaphragm or cervical cap fitting

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Diaphragm/Cervical Cap Fitting W/Instructions

Payers reporting CPT 57170

Payer pricing summary

Low

$35

Average

$545

Median

$245

High

$6.5k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +33 other terms	530	$201	$661	$1.5k	220%	—	$1 – $17.9k
2	Aetna fee schedule · outpatient · +34 other terms	461	$207	$948	$2.8k	295%	—	$1 – $33.6k
3	Humana fee schedule · outpatient · +28 other terms	372	$196	$331	$938	284%	—	$1 – $12.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +30 other terms	368	$261	$534	$1.1k	209%	—	$1 – $14.4k
5	Cigna case rate · outpatient · +25 other terms	240	$1.3k	$4.3k	$7.1k	166%	—	$0 – $40.7k
6	Molina fee schedule · outpatient · +26 other terms	222	$90	$128	$339	265%	—	$1 – $5.8k
7	WellCare fee schedule · outpatient · +19 other terms	171	$202	$284	$551	194%	—	$38 – $4.3k
8	Anthem fee schedule · outpatient · +29 other terms	126	$196	$264	$595	225%	—	$24 – $6.3k
9	Oscar case rate · outpatient · +17 other terms	120	$2.7k	$3.8k	$1.9k	49%	—	$315 – $7.5k
10	Kaiser fee schedule · outpatient · +19 other terms	100	$273	$410	$657	160%	—	$3 – $4.3k
11	Ambetter fee schedule · outpatient · +15 other terms	73	$341	$297	$287	97%	—	$25 – $2.3k
12	Devoted fee schedule · outpatient · +12 other terms	72	$206	$190	$54	29%	—	$45 – $319
13	Aetna Better Health fee schedule · outpatient · +14 other terms	66	$45	$50	$27	54%	—	$37 – $189
14	Caresource fee schedule · outpatient · +12 other terms	58	$219	$373	$854	229%	—	$1 – $4.3k
15	Optum fee schedule · outpatient · +21 other terms	57	$184	$198	$148	75%	—	$42 – $746
16	Healthcare Highways case rate · outpatient · +1 other terms	42	$5.8k	$6.6k	$5.1k	78%	—	$2.1k – $14.6k
17	Superior Healthplan case rate · outpatient · +4 other terms	38	$948	$933	$89	9%	—	$302 – $948
18	MultiPlan fee schedule · outpatient · +20 other terms	37	$285	$320	$176	55%	—	$23 – $1.6k
19	Bcbs Tx fee schedule · outpatient · +2 other terms	33	$77	$72	$51	72%	—	$28 – $207
20	Cigna Healthspring fee schedule · outpatient · +7 other terms	32	$43	$100	$79	79%	—	$38 – $211
21	Clover fee schedule · outpatient · +7 other terms	31	$225	$775	$1.4k	175%	—	$182 – $4.3k
22	Tricare fee schedule · outpatient · +16 other terms	31	$183	$837	$1.7k	202%	—	$26 – $5.1k
23	Medica fee schedule · outpatient · +12 other terms	29	$212	$445	$552	124%	—	$8 – $1.5k
24	Regence professional · fee schedule · outpatient · +13 other terms	26	$61	$114	$61	54%	—	$47 – $248
25	Bcbs La fee schedule · outpatient · +2 other terms	25	$76	$148	$210	142%	—	$31 – $1.1k

Page 1 of 3 · 62 payers