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Michigan rates for HCPCS 54405

Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,026.67 / $4,112.00 / $11,031.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,725.98 / $27,695.37 / $37,728.69
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$820.04 / $4,112.00 / $8,305.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,301.00 / $12,831.00 / $34,988.93