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North Dakota 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
$602.56 / $741.31 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $741.31 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,412.54 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,698.24 / $2,137.96 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $1,230.27 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,023.29 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,318.26 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,311.31 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,096.48 / $1,621.81