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Indiana 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
$1,380.38 / $4,897.79 / $16,218.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $18,197.01 / $26,302.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,047.13 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $9,549.93 / $16,218.10