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Montana rates for HCPCS 54408

Repair of component(s) of a multi-component, inflatable penile 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
$1,244.04 / $1,244.04 / $1,244.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.69 / $1,473.55 / $1,512.94