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Rhode Island 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
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $831.76 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,174.90 / $4,265.80 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $660.69 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $741.31 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,677.35 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $741.31 / $1,148.15