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West Virginia rates for HCPCS 67904

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

Facilitymedian $2,630 · 10th–90th $646$6,6070%20%10th90th$2,630Professionalmedian $708 · 10th–90th $550$1,0470%10%20%10th90th$708$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
$645.65 / $5,248.07 / $6,606.93
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $707.95 / $1,000.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $724.44
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $2,511.89
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
$501.19 / $812.83 / $4,786.30
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,691.53 / $5,370.32 / $12,882.50
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $645.65 / $1,047.13