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South Dakota rates for HCPCS 67902

Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)

Facilitymedian $1,072 · 10th–90th $724–$4,8980%20%10th90th$1,072Professionalmedian $1,096 · 10th–90th $724–$1,9500%20%10th90th$1,096$500.0$1.0K$2.0K$5.0K

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
$776.25 / $4,365.16 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $776.25 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,698.24 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $912.01 / $2,041.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,148.15 / $2,238.72
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,737.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,202.26 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,288.25 / $2,041.74
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,659.59 / $1,659.59