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Indiana 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
$1,284.13 / $4,301.66 / $17,225.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,427.00 / $11,294.00 / $22,813.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.45 / $1,894.71 / $2,842.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $3,909.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,699.00 / $10,000.00 / $15,750.00