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Montana rates for HCPCS 54135

Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,570.78 / $7,944.94 / $7,944.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,357.69 / $2,357.69 / $2,357.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,739.82 / $2,357.69 / $2,526.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,165.64 / $2,835.95 / $2,898.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.66 / $2,138.71 / $3,084.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,271.36 / $2,620.80 / $4,103.30