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Washington 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
$2,112.92 / $6,470.00 / $27,982.24
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,866.94 / $16,595.73 / $31,745.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,147.74 / $4,147.74 / $6,910.09
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,885.80 / $3,205.76 / $11,234.92
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,025.60 / $2,771.12 / $2,989.96
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,019.93 / $2,031.37 / $2,513.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,761.59 / $16,586.25 / $31,745.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,312.00 / $21,157.82 / $33,842.43