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Texas 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
$1,002.24 / $3,682.00 / $11,232.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,997.44 / $7,227.29 / $14,309.06
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$917.27 / $8,530.40 / $8,530.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,187.68 / $4,187.68 / $4,187.68
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,500.00 / $26,542.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,002.24 / $1,327.66 / $2,392.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,002.24 / $1,353.37 / $2,728.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.00 / $6,000.00 / $13,134.00