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Nebraska rates for HCPCS C2622

Prosthesis, penile, noninflatable

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.06 / $2,164.52 / $3,798.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $6,595.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.19 / $2,371.19 / $3,768.95