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Wisconsin 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
$1,258.93 / $2,754.23 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,964.78 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $4,073.80 / $6,606.93
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $6,918.31 / $13,182.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $7,585.78 / $15,848.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $3,019.95 / $4,365.16
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $16,595.87 / $16,595.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $12,302.69 / $16,218.10