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Montana rates for HCPCS 54415

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

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$841.28 / $841.28 / $841.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.50 / $981.50 / $1,010.10