go back

Pennsylvania 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
$832.00 / $3,745.00 / $8,017.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.00 / $549.00 / $549.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,600.55 / $10,774.65 / $17,523.29
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,839.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.00 / $549.00 / $549.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.54 / $627.88 / $969.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.00 / $2,884.00 / $6,000.00