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Maine rates for HCPCS 67904

Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.16 / $915.16 / $1,137.23
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$20,987.54 / $20,987.54 / $20,987.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.99 / $797.02 / $1,174.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.74 / $764.28 / $983.62
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$946.12 / $1,146.42 / $1,475.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,005.81 / $1,005.81 / $1,005.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.28 / $1,156.07 / $1,489.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.59 / $903.95 / $1,406.55
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$20,987.54 / $20,987.54 / $20,987.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.99 / $797.02 / $1,237.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.27 / $1,010.49 / $1,306.67