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Wisconsin 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
$0.87 / $3,801.89 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $4,786.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,737.80 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,754.23 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,630.27 / $3,019.95
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $4,897.79 / $9,549.93
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,187.76 / $2,754.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $7,244.36 / $15,848.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,412.54 / $7,762.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $741.31
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,041.74 / $2,951.21
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $4,265.80 / $7,762.47
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $4,265.80 / $5,011.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $12,302.69 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,318.26 / $3,715.35