go back

Staged Repair of the Urine Tube in the Penis

Pennsylvania rates for HCPCS 54316

Builds a new section of the tube that carries urine along the penis, as one stage of the repair of hypospadias — a difference present from birth in which the opening sits on the underside of the penis rather than at the tip. The new section is formed and the skin closed over it.

Rates data updated July 2026.

How much does Staged Repair of the Urine Tube in the Penis cost?

$1,259

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,259 for this service. The price depends on where it is billed: about $1,023 from a physician practice, and about $4,786 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,023$912 to $1,202
FacilityA hospital or hospital-owned outpatient department$4,786$2,951 to $6,761

How much rates vary

Facilitymedian $4,786 · 10th to 90th $1,047 to $8,318Professionalmedian $1,023 · 10th to 90th $871 to $1,698
$1K$2K$5K$10K$20Kfacility $4,786professional $1,023

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$4,786.30
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,000.00
Typical High
$1,412.54
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$7,585.78
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$1,230.27
Typical High
$1,949.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,513.56
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,230.27
Typical High
$1,949.84
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$3,890.45
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,047.13
Typical High
$3,715.35
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,380.38
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$5,495.41
Typical High
$9,549.93
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$977.24
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$4,466.84
Typical High
$28,183.83
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,174.90
Typical High
$1,995.26

Where Pennsylvania sits

The same service costs 6.2 times more in California than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 46th of 51

$1,259

CA $6,607DE $1,072

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.