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Indiana rates for HCPCS 69631

Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$929.82 / $6,349.62 / $16,042.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.71 / $815.64 / $1,663.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,719.00 / $10,700.00 / $17,513.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.48 / $1,014.36 / $1,399.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$878.33 / $1,197.72 / $1,796.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.40 / $1,038.02 / $1,437.27
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
$763.11 / $1,120.09 / $1,896.35
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
$793.64 / $958.18 / $1,731.62