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Pennsylvania rates for HCPCS 54111

Excision of penile plaque (Peyronie disease); with graft to 5 cm in length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.54 / $808.01 / $1,014.49
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.11 / $829.27 / $829.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$770.88 / $1,031.95 / $1,623.89
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.33 / $1,230.81 / $1,235.35
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,085.06 / $14,085.06 / $14,085.06
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.00 / $3,120.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.00 / $857.95 / $2,843.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $1,082.09 / $1,980.70
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$781.10 / $1,041.83 / $1,685.41
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.07 / $776.07 / $976.74
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.53 / $779.88 / $976.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $3,914.00 / $7,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.48 / $1,052.18 / $1,664.75