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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
$478.63 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $758.58 / $1,479.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,174.90 / $1,230.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $891.25 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28