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Texas 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
$1,244.00 / $3,792.00 / $13,004.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,121.85 / $7,421.31 / $14,454.58
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,313.40 / $5,397.10 / $11,491.84
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,247.39 / $1,247.39 / $1,247.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,187.68 / $4,187.68 / $4,187.68
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,500.00 / $26,542.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.28 / $1,792.74 / $3,048.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.28 / $1,810.24 / $3,408.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.00 / $6,000.00 / $13,134.00