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Pennsylvania rates for HCPCS 54112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$857.78 / $2,747.00 / $8,017.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,948.60 / $24,948.60 / $31,185.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.00 / $3,120.00 / $8,017.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$909.64 / $909.64 / $1,086.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $3,914.00 / $7,000.00