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Arizona rates for HCPCS 53454

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,170.00 / $2,640.00 / $5,506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.51 / $46.48 / $53.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.35 / $2,197.38 / $3,616.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.45 / $140.60 / $175.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.78 / $240.78 / $240.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.14 / $23.78 / $41.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.98 / $61.18 / $1,448.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.12 / $26.57 / $333.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.00 / $1,535.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.48 / $24.96 / $50.67