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Extensive Repair of a Severe Urethral Birth Defect

West Virginia rates for HCPCS 54336

This is an extensive one-stage surgery to correct a birth condition in which the opening for urine is located in the perineal area, well behind the base of the penis, rather than at the tip. The surgeon reconstructs a new channel for urine using skin flaps or grafts, often correcting any associated curvature of the penis in the same operation.

Rates data updated July 2026.

How much does Extensive Repair of a Severe Urethral Birth Defect cost?

$1,349

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $1,349 for this service. The price depends on where it is billed: about $1,349 from a physician practice, and about $1,202 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 4 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$1,349$1,202 to $1,349
FacilityA hospital or hospital-owned outpatient department$1,202$1,202 to $1,514

How much rates vary

Facilitymedian $1,202 · 10th to 90th $1,202 to $3,631Professionalmedian $1,349 · 10th to 90th $1,202 to $1,698
$50$200$1K$5Kfacility $1,202professional $1,349

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
$1,202.26
Median
$1,202.26
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,258.93
Typical High
$1,348.96
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,513.56
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,905.46
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,778.28
Typical High
$8,128.31
United
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$3,235.94
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,348.96
Typical High
$2,089.30

Where West Virginia sits

The same service costs 5.6 times more in California than in Hawaii. 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.

West Virginia· 46th of 51

$1,349

CA $6,761HI $1,202

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.