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Montana rates for HCPCS 54406

Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.45 / $1,150.45 / $1,150.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.17 / $1,363.05 / $1,398.46