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Pennsylvania 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
$1,148.15 / $6,456.54 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $3,388.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,348.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,348.96 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,071.52 / $1,737.80
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,230.27 / $1,348.96
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $1,698.24
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $12,589.25 / $26,302.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,623.41 / $14,125.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,230.27 / $2,630.27
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,862.09
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,412.54 / $1,905.46
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $933.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $4,466.84 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $977.24 / $1,737.80