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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
$831.76 / $2,630.27 / $7,762.47
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,754.23 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $707.95 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$812.83 / $831.76 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $7,943.28 / $12,882.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $758.58 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $758.58 / $977.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,000.00 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $741.31 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $3,235.94 / $5,888.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $645.65 / $870.96