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Virginia 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
$2,362.09 / $6,827.70 / $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
$1,265.90 / $1,519.08 / $1,873.53
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,467.04 / $1,789.46 / $2,605.66
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,344.91 / $1,758.82 / $6,585.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,693.00 / $11,671.00 / $21,639.00