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South Dakota rates for HCPCS 54417

Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$808.47 / $808.47 / $808.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.74 / $1,112.74 / $2,324.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,967.24 / $2,017.09 / $2,521.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,073.56 / $1,366.31 / $2,403.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.61 / $1,786.04 / $6,696.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,398.25 / $2,224.58 / $2,742.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,399.00 / $1,967.24 / $2,381.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.70 / $1,496.34 / $1,748.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.32 / $1,786.04 / $2,505.13
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,704.10 / $2,004.80 / $2,085.00