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Oklahoma 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
$1,000.07 / $4,112.00 / $13,200.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,758.50 / $5,505.60 / $5,505.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.62 / $709.00 / $805.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,343.15 / $8,501.96 / $13,529.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.70 / $769.92 / $966.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,070.25 / $1,070.25 / $1,070.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.28 / $772.37 / $974.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.47 / $1,003.99 / $5,834.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.15 / $729.45 / $7,208.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$884.00 / $2,900.00 / $5,543.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.99 / $717.24 / $943.74