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Utah rates for HCPCS 54304

Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $851.14 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,023.29 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,445.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $6,025.60 / $13,489.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,148.15 / $3,548.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,380.38 / $1,584.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,148.15 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $891.25 / $1,548.82