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Arizona rates for HCPCS 67904

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $758.58 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$741.31 / $1,445.44 / $5,370.32
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $478.63 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$776.25 / $794.33 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $2,511.89 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $660.69 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $707.95 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $1,096.48 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,801.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $758.58 / $7,244.36
Medica
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$831.76 / $831.76 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,019.95 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $630.96 / $1,122.02