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Wyoming 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
$2,700.00 / $2,700.00 / $3,600.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,738.00 / $2,809.00 / $3,513.00
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$2,607.00 / $4,213.50 / $5,269.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.98 / $967.18 / $1,413.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,607.00 / $2,607.00 / $10,877.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.87 / $1,457.13 / $2,386.81