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Indiana rates for HCPCS 69604

Revj Mastoidectomy Rsltg Tympanoplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,019.05 / $4,580.00 / $17,225.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.58 / $1,019.05 / $1,418.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,427.00 / $11,294.00 / $22,813.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.80 / $1,346.00 / $1,857.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,062.64 / $1,500.20 / $2,250.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,020.13 / $1,250.16 / $1,800.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $3,909.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,043.66 / $1,416.05 / $2,355.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,699.00 / $10,000.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.52 / $1,200.16 / $2,165.69