go back

South Dakota rates for HCPCS 54400

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$481.08 / $481.08 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$639.29 / $813.03 / $1,483.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$925.00 / $1,392.08 / $21,077.77
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.41 / $883.14 / $1,038.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00