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Connecticut 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
$1,445.44 / $5,888.44 / $10,471.29
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,630.27 / $8,511.38 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $870.96 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,071.52 / $2,041.74 / $5,495.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,168.69 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,202.26 / $1,513.56
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,047.13 / $1,778.28 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $933.25 / $1,995.26
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $933.25 / $1,258.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $7,079.46 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $776.25 / $1,737.80