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California rates for HCPCS 69633

Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $10,232.93 / $20,892.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $11,481.54 / $17,782.79
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $5,495.41 / $13,182.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $4,365.16
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $1,548.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,230.27 / $2,344.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,595.87 / $42,657.95 / $42,657.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,380.38 / $2,344.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $12,302.69 / $25,703.96