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Missouri 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
$1,400.00 / $4,610.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,500.00 / $21,783.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,436.00 / $7,469.00 / $11,141.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$566.55 / $1,122.33 / $22,240.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.00 / $3,527.00 / $6,854.00