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South Dakota rates for HCPCS 69635

Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,273.14 / $1,273.14 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,251.75 / $2,151.61 / $3,522.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,010.00 / $3,290.03 / $5,269.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,521.97 / $2,114.92 / $2,487.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00