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Montana 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,819.70 / $2,137.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,513.56 / $1,819.70