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Epispadias Repair With Bladder Exstrophy

West Virginia rates for HCPCS 54390

Reconstructive surgery on the penis for epispadias, a birth defect in which the urinary opening lies along the top of the penis instead of at the tip. This version is performed when the child also has bladder exstrophy, where the bladder is open onto the surface of the lower abdomen at birth, so the repair addresses both the penis and the bladder defect. It is major reconstructive surgery, usually done in stages during early childhood.

Rates data updated July 2026.

How much does Epispadias Repair With Bladder Exstrophy 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 $1,413 from a physician practice, and about $1,259 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$1,413$1,259 to $1,413
FacilityA hospital or hospital-owned outpatient department$1,259$1,259 to $1,413

How much rates vary

Facilitymedian $1,259 · 10th to 90th $1,259 to $1,950Professionalmedian $1,413 · 10th to 90th $1,259 to $1,778
$50$200$1K$5Kfacility $1,259professional $1,413

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
$1,258.93
Median
$1,258.93
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,318.26
Typical High
$1,412.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,584.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,949.84
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,778.28
Typical High
$12,882.50
United
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$4,073.80
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,348.96
Typical High
$2,089.30

Where West Virginia sits

The same service costs 5.5 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· 49th of 51

$1,349

CA $7,079HI $1,288

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.