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Michigan rates for HCPCS 67904

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

Facilitymedian $4,898 · 10th–90th $813$7,2440%10%20%10th90th$4,898Professionalmedian $813 · 10th–90th $575$1,5140%20%10th90th$813$0.5$2.0$10.0$50.0$200.0$1.0K$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
$812.83 / $2,137.96 / $7,244.36
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$794.33 / $977.24 / $3,090.30
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,318.26 / $1,318.26
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $707.95 / $1,348.96
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $2,137.96 / $6,918.31
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $6,456.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $851.14 / $1,348.96
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$794.33 / $977.24 / $3,090.30
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $691.83 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $4,073.80 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,071.52