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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
$962.33 / $3,680.18 / $16,042.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,719.00 / $10,700.00 / $17,513.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,004.20 / $1,417.70 / $2,126.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $3,909.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,699.00 / $10,000.00 / $15,750.00