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Montana rates for HCPCS 67903

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.76 / $532.70 / $975.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.79 / $749.79 / $948.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$749.79 / $749.79 / $749.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.52 / $675.65 / $973.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$535.08 / $784.24 / $1,539.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.55 / $719.75 / $973.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $1,450.00 / $1,450.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.08 / $955.32 / $1,138.99