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Ohio rates for HCPCS 53405

Urethroplasty; second stage (formation of urethra), including urinary diversion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.80 / $3,696.00 / $10,635.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.73 / $869.40 / $2,360.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,003.00 / $3,555.00 / $19,117.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.00 / $943.64 / $1,673.32
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.52 / $990.62 / $1,226.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$908.07 / $908.07 / $968.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.86 / $1,205.17 / $1,775.01
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$815.79 / $1,248.19 / $1,714.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.89 / $876.60 / $1,248.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,840.00 / $5,998.00 / $7,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$845.08 / $1,127.89 / $1,937.14