go back

Missouri 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
$1,110.00 / $3,158.00 / $8,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.05 / $39.40 / $40.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.70 / $10.07 / $17.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.60 / $40.04 / $235.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.35 / $59.12 / $932.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.68 / $40.02 / $333.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $760.00 / $1,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.10 / $32.00 / $67.95