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Virginia 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
$1,564.48 / $6,705.00 / $14,798.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,153.00 / $7,363.00 / $9,410.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,332.79 / $1,599.35 / $1,972.53
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,555.01 / $1,912.27 / $2,722.07
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,368.78 / $1,847.73 / $6,585.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,693.00 / $11,671.00 / $21,639.00