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New Hampshire rates for HCPCS 67904

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

Facilitymedian $2,399 · 10th–90th $1,698–$14,7910%20%10th90th$2,399Professionalmedian $912 · 10th–90th $603–$1,8620%10%10th90th$912$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,949.84 / $2,398.83 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $891.25 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$758.58 / $1,445.44 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,047.13 / $1,778.28
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,071.52 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,023.29 / $2,187.76
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01