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California rates for HCPCS 67904

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

Facilitymedian $9,333 · 10th–90th $3,162$17,7830%10%10th90th$9,333Professionalmedian $794 · 10th–90th $525$2,4550%10%10th90th$794$50.0$200.0$1.0K$5.0K$20.0K

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
$3,311.31 / $8,912.51 / $18,197.01
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$645.65 / $11,220.18 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $707.95 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$794.33 / $977.24 / $5,248.07
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $10,471.29 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,949.84
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$870.96 / $1,202.26 / $2,137.96
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $6,309.57 / $13,182.57
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $776.25 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,445.44 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $851.14 / $1,584.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $831.76 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $794.33 / $1,445.44
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $33,884.42 / $33,884.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,023.29
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $891.25 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $851.14 / $1,659.59
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,454.71
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $851.14 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $7,244.36 / $14,454.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $676.08 / $1,548.82
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54