go back

California rates for HCPCS 69637

Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); 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
$2,645.00 / $9,697.00 / $22,210.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,585.00 / $11,216.00 / $21,514.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $15,436.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,685.47 / $4,355.56 / $10,261.32
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.90 / $1,698.87 / $2,293.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.21 / $1,871.31 / $3,392.61
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,720.68 / $16,547.20 / $26,542.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,411.36 / $1,817.82 / $2,711.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,799.00 / $12,341.00 / $26,672.00