go back

Washington rates for HCPCS 69667

Repair Round Window Fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.81 / $5,116.62 / $21,917.86
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,308.60 / $9,124.02 / $23,606.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,982.56 / $1,982.56 / $3,302.92
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,029.42 / $1,764.68 / $8,266.54
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,149.89 / $1,536.31 / $1,649.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,098.53 / $1,119.65 / $1,140.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,916.52 / $9,101.25 / $17,453.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,550.00 / $2,431.00 / $11,261.00