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New York 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
$1,722.55 / $5,700.00 / $12,075.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,274.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,049.31 / $3,478.50 / $13,477.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,573.68 / $1,573.68 / $10,297.11
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $2,116.00 / $3,642.05
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,573.68 / $10,297.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,337.00 / $6,450.00 / $12,742.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,492.84 / $1,492.84 / $4,534.16