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Pennsylvania 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
$882.00 / $4,070.00 / $9,406.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,223.60 / $44,319.84 / $70,866.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,964.00 / $8,247.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$785.44 / $785.44 / $1,246.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,960.00 / $12,227.00 / $64,785.95