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South Dakota rates for HCPCS 67903

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

Facilitymedian $646 · 10th–90th $479–$4,3650%10%20%10th90th$646Professionalmedian $708 · 10th–90th $479–$1,2880%10%10th90th$708$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
$512.86 / $645.65 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,412.54 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $724.44 / $1,445.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $954.99 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,380.38 / $1,445.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,000.00 / $1,621.81
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,380.38