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Michigan rates for HCPCS 67903

Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.41 / $808.05 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.62 / $570.89 / $805.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,065.78 / $2,407.73 / $3,262.10
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,181.41 / $1,701.74 / $2,211.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.33 / $711.62 / $1,120.80
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,141.64 / $1,429.23 / $1,429.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.29 / $566.86 / $941.40
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.62 / $777.19 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.04 / $626.80 / $951.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.99 / $412.09 / $683.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,708.00 / $8,884.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.21 / $700.62 / $915.04