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Delaware 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
$6,025.60 / $6,025.60 / $7,244.36
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$251.19 / $831.76 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $630.96 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $616.60 / $851.14