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Arizona rates for HCPCS C2622

Prosthesis, penile, noninflatable

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,989.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,470.60 / $8,925.04 / $16,136.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,852.95 / $2,470.60 / $3,366.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $4,145.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95