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New York rates for HCPCS 69642

Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,629.60 / $5,919.00 / $13,229.00
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
$1,916.52 / $3,478.50 / $13,477.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,503.96 / $1,503.96 / $10,297.11
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $2,268.71 / $3,811.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,672.00 / $9,164.64 / $10,178.52
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,503.96 / $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
$1,428.47 / $1,428.47 / $4,414.01