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Idaho rates for HCPCS 54390

Plastic Rpr Penis Epispadias W/Exstrophy Bladder

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,624.92 / $1,752.18 / $2,482.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,743.42 / $2,134.17 / $2,382.67
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,432.20 / $2,156.48 / $2,631.04
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,983.83 / $2,104.06 / $2,404.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,735.32 / $2,183.14
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,888.97 / $1,888.97 / $2,323.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,120.00 / $22,317.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,035.33 / $1,672.66 / $2,601.90