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Vermont rates for HCPCS 67904

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $794.33 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,148.15 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,000.00 / $1,288.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $851.14 / $2,454.71