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Texas rates for HCPCS 67904

Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.97 / $3,445.00 / $10,836.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,298.00 / $2,461.55 / $9,702.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.99 / $735.40 / $1,135.17
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$733.32 / $835.47 / $4,506.14
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.99 / $554.99 / $599.39
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$832.48 / $1,010.42 / $1,599.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,644.92 / $2,999.56 / $6,086.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.84 / $681.80 / $983.85
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$769.00 / $2,190.60 / $5,199.47
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.96 / $776.99 / $1,094.85
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.82 / $1,090.21 / $1,090.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,263.04 / $1,263.04 / $1,304.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.10 / $816.51 / $1,159.01
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,054.44 / $26,542.00 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,208.00 / $7,208.00 / $7,208.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.48 / $818.26 / $1,321.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.78 / $886.70 / $1,205.91
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$979.91 / $1,031.01 / $1,764.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.83 / $718.50 / $887.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.48 / $819.47 / $1,375.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.94 / $829.65 / $1,221.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.00 / $3,264.00 / $7,600.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.24 / $754.99 / $1,110.65
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.41 / $684.29 / $961.98