go back

Pennsylvania rates for HCPCS 54406

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$768.00 / $3,745.00 / $8,017.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,964.00 / $8,017.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.22 / $710.78 / $710.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,000.00