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Hawaii 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
$1,861.43 / $2,747.00 / $6,084.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,184.83 / $1,292.54 / $1,507.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $2,912.00 / $2,912.00