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Virginia rates for HCPCS 67904

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

Facilitymedian $3,715 · 10th–90th $631$9,7720%5%10%10th90th$3,715Professionalmedian $871 · 10th–90th $550$3,5480%10%10th90th$871$500.0$1.0K$2.0K$5.0K$10.0K

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
$758.58 / $3,981.07 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$9,120.11 / $9,772.37 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$251.19 / $2,041.74 / $5,495.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,148.15
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$851.14 / $1,202.26 / $1,737.80
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $616.60 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
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
$549.54 / $794.33 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $851.14 / $1,071.52
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,000.00
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,318.26
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $741.31 / $8,709.64
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $8,709.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $6,025.60 / $12,882.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $645.65 / $1,202.26