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Maryland rates for HCPCS 67904

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

Facilitymedian $2,951 · 10th–90th $1,820–$4,5710%20%10th90th$2,951Professionalmedian $832 · 10th–90th $575–$1,4450%10%10th90th$832$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,818.38 / $2,951.21 / $4,570.88
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,819.70 / $3,801.89 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$251.19 / $1,096.48 / $2,041.74
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $616.60 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $630.96 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,348.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $1,258.93
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $831.76 / $1,230.27