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Montana rates for HCPCS 54400

Insertion of penile prosthesis; non-inflatable (semi-rigid)

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $912.01 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $776.25 / $1,023.29