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North Dakota rates for HCPCS 67912

Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.79 / $915.62 / $8,500.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.79 / $959.57 / $1,780.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,545.00 / $2,545.00 / $2,545.00