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Pennsylvania rates for HCPCS 54385

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

Facilitymedian $4,467 · 10th–90th $1,047–$8,3180%10%10th90th$4,467Professionalmedian $1,047 · 10th–90th $851–$1,7780%20%10th90th$1,047$5.0$20.0$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
$1,047.13 / $4,786.30 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,047.13 / $1,778.28
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $1,148.15 / $1,819.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,412.54
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,174.90 / $1,819.70
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,630.78 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $1,584.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,479.11 / $2,089.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,096.48 / $1,318.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,265.80 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,096.48 / $1,862.09