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Michigan rates for HCPCS 54415

Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $794.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $4,073.80 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $5,888.44 / $10,000.00