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South Dakota 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
$481.81 / $481.81 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.48 / $814.26 / $1,481.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.00 / $1,390.28 / $3,079.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.68 / $884.24 / $1,040.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00