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Michigan rates for HCPCS 54115

Removal foreign body from deep penile tissue (eg, plastic implant)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.08 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.69 / $540.08 / $577.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,068.66 / $2,414.75 / $3,289.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.02 / $382.60 / $773.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.62 / $586.20 / $769.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.01 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.01 / $523.26 / $737.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.75 / $392.68 / $596.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,243.34 / $5,574.00 / $8,339.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.22 / $597.61 / $755.28