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Wisconsin rates for HCPCS 67901

Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)

Facilitymedian $4,786 · 10th–90th $1,413–$7,7620%10%10th90th$4,786Professionalmedian $1,622 · 10th–90th $871–$2,7540%10%10th90th$1,622$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,202.26 / $9,332.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,786.30 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,511.89 / $3,981.07
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,202.26 / $6,918.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,412.54 / $8,128.31
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,754.40 / $7,762.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,621.81 / $2,754.23
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,754.40 / $5,754.40
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,801.89
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $7,413.10 / $9,120.11