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New York rates for HCPCS 54385

Plastic operation on penis for epispadias distal to external sphincter; with incontinence

Facilitymedian $4,571 · 10th–90th $1,413–$10,0000%5%10th90th$4,571Professionalmedian $1,148 · 10th–90th $813–$2,8840%10%10th90th$1,148$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $4,265.80 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,202.26 / $3,090.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $2,454.71
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,995.26 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $4,786.30 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,737.80 / $4,168.69
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $3,235.94
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,288.25 / $1,737.80
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,230.27 / $1,995.26
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,230.27 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,786.30 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,230.27 / $3,019.95
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,230.27 / $3,235.94
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,230.27 / $2,951.21