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Montana 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,219.40 / $2,219.40 / $2,219.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,088.42 / $2,344.55 / $2,573.64