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Maine 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
$1,548.82 / $6,165.95 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $933.25 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,258.93 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,174.90 / $1,995.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,202.26 / $1,819.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $6,165.95 / $9,549.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,023.29 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,258.93 / $1,995.26