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Maryland 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
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,090.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,548.82 / $2,630.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03