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Pennsylvania 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
$1,148.15 / $6,025.60 / $10,715.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $10,000.00 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $15,135.61 / $30,902.95
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,370.32 / $10,715.19
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $2,187.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $4,466.84 / $18,197.01