go back

West Virginia rates for HCPCS 69604

Revision mastoidectomy; resulting in tympanoplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.36 / $1,083.36 / $3,550.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.84 / $1,083.36 / $1,239.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.89 / $1,268.26 / $1,381.78
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,228.25 / $1,228.25 / $1,228.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,250.82 / $1,250.82 / $1,250.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,079.56 / $1,535.31 / $5,886.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.61 / $1,246.45 / $1,801.52