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Utah 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
$707.95 / $5,888.44 / $8,511.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $6,025.60 / $13,489.63
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $831.76 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64