Price Checker / CPT 54400
How much does Insert Semi-rigid Prosthesis cost?
CPT 54400 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 53x the fair price — among the most extreme markups. Dispute this.
Fair price
$730–$1,450
What this should cost
With insurance
~$6,000
Typical out-of-pocket
Overcharged if over
$1,800
Push back above this
The average hospital charge of $58,403 is $57,303 over the fair price (about 53x the fair rate).
What hospitals charge for Insert Semi-rigid Prosthesis
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Palm Bay Hospital Palm Bay, FL | $153,333 | — | 35310% |
| Southlake Specialty Hospital LLC Southlake, TX | — | — | 30179% |
| "MultiCare Mary Bridge Children's Hospital" , WA | — | — | 26999% |
| McLaren Flint FLINT, MI | $91,574 | $45,787 | 18782% |
| Lincoln Health Damariscotta, ME | — | — | 15923% |
| MultiCare Good Samaritan Hospital PUYALLUP, WA | — | — | 14824% |
| Crockett Medical Center Crockett, TX | $95,470 | — | 13680% |
| Waldo County General Hospital Belfast, ME | — | — | 13062% |
| Stephens Memorial Hospital Norway, ME | — | — | 12225% |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH Fort Worth, TX | — | — | 12148% |
| St. Anne Hospital , WA | — | — | 12125% |
| Grady Memorial Hospital CHICKASHA, OK | — | $0 | 11919% |
| Mid Coast Hospital , ME | — | — | 9257% |
| NORTHEAST METHODIST San Antonio, TX | — | — | 9249% |
| MaineHealth - Memorial Hospital North Conway, NH | — | — | 8973% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Insert Semi-rigid Prosthesis
CPT code 54400 refers to insert semi-rigid prosthesis (billing description: "Insert semi-rigid prosthesis"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $485 in a facility (hospital or surgery center) and $485 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.