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New Mexico 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
$624.61 / $2,040.00 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.87 / $644.54 / $1,237.32
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$733.32 / $835.47 / $4,506.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,835.94 / $6,357.37 / $9,865.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.68 / $714.15 / $1,074.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,800.00 / $3,800.00 / $3,800.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.89 / $893.10 / $1,270.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $618.79 / $1,246.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$532.61 / $729.81 / $1,575.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.92 / $875.22 / $1,270.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$639.00 / $5,971.00 / $8,422.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.23 / $983.23 / $1,288.20