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Pennsylvania rates for HCPCS 54115

Removal Foreign Body Deep Penile Tissue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.78 / $2,070.00 / $7,629.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.32 / $427.43 / $586.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.82 / $476.14 / $476.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.58 / $562.71 / $866.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.04 / $714.76 / $722.87
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.00 / $2,326.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.32 / $457.06 / $1,234.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $721.10 / $1,157.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.61 / $572.75 / $908.99
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$414.35 / $444.07 / $680.07
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.35 / $444.07 / $531.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.20 / $568.85 / $959.97