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New York rates for HCPCS 67904

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

Facilitymedian $4,677 · 10th–90th $891$11,4820%5%10th90th$4,677Professionalmedian $851 · 10th–90th $575$1,9500%10%10th90th$851$100.0$500.0$2.0K$10.0K$50.0K

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
$851.14 / $4,073.80 / $11,748.98
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$5,248.07 / $7,413.10 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $776.25 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$794.33 / $977.24 / $2,041.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,772.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $794.33 / $1,862.09
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $2,754.23
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,398.83 / $10,964.78
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $2,511.89 / $53,703.18
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $912.01 / $2,344.23
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $1,949.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,047.13 / $1,548.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $891.25 / $1,548.82
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $912.01
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$831.76 / $1,096.48 / $1,096.48
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $912.01 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,981.07 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $776.25 / $1,862.09
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $812.83 / $1,548.82
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $812.83 / $2,398.83