go back

Utah rates for HCPCS 69604

Revision mastoidectomy; resulting in tympanoplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $6,025.60 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,122.02 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,479.11 / $2,398.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,570.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $10,000.00 / $22,387.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,819.70 / $6,165.95
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,995.26 / $2,691.53
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,698.24 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $2,290.87