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Wisconsin rates for HCPCS 54415

Rmvl Non-Nfltbl/Nfltbl Penile Prosth W/O Rplcmt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.38 / $1,099.01 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $8,139.00 / $11,136.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,385.02 / $1,618.51 / $2,610.59
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.29 / $727.57 / $1,050.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.38 / $4,240.00 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.29 / $727.57 / $1,050.17
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.20 / $1,613.95 / $1,901.14
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,388.90 / $9,388.90 / $9,388.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00