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South Dakota rates for HCPCS 69645

Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,476.89 / $1,476.89 / $4,338.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,505.76 / $2,495.94 / $4,092.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,428.00 / $3,877.93 / $5,269.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,792.15 / $2,444.86 / $2,876.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00