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Illinois rates for HCPCS 67904

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

Facilitymedian $3,631 · 10th–90th $851–$9,7720%5%10th90th$3,631Professionalmedian $912 · 10th–90th $603–$2,3440%10%10th90th$912$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
$831.76 / $3,548.13 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,862.09 / $5,128.61 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $870.96 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$831.76 / $1,445.44 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,715.35 / $12,589.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,047.13 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $912.01 / $1,348.96
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $1,047.13 / $3,467.37
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $724.44 / $954.99
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,467.37 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $1,412.54