Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HB Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl
Low
$1
Average
$4.2k
Median
$3.1k
High
$31.4k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
1346 hospitals; the 90th percentile is 7.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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1,986 hospital rates
iThe hospitals that file a UnitedHealthcare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 3 | $22.8k | $25.1k | $4.6k | 18% | 65–74 | $22.8k – $34.3k |
| 2 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 3 | $14.2k | $15.4k | $4.4k | 29% | 48 | $10.7k – $21.3k |
| 3 | HARTFORD HOSPITAL HARTFORD, CT other · outpatient | 1 | $972 | $972 | — | — | 44 | $972 – $972 |
| 4 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · inpatient | 4 | $2.4k | $2.3k | $1.4k | 61% | 29–56 | $671 – $3.8k |
| 5 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 3 | $2.3k | $2.7k | $559 | 20% | 12–21 | $2.3k – $3.5k |
| 6 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 3 | $2.3k | $2.7k | $559 | 20% | 12–21 | $2.3k – $3.5k |
| 7 | Northwestern Medicine Kishwaukee Hospital DeKalb, IL percent of total billed charges · outpatientfrom % of charges | 3 | $18.3k | $20.4k | $6.4k | 32% | 3–30 | $13.8k – $29.1k |
| 8 | Crouse Hospital Syracuse, NY percent of total billed charges · outpatientfrom % of charges | 1 | $2.2k | $2.2k | $39 | 2% | 2–20 | $2.2k – $2.2k |
| 9 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · outpatientfrom % of charges | 5 | $3.5k | $3.4k | $203 | 6% | 2–20 | $3.0k – $3.5k |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN percent of total billed charges · outpatientfrom % of charges | 1 | $8.2k | $8.2k | $2.4k | 29% | 2–20 | $5.8k – $10.6k |
| 11 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN percent of total billed charges · outpatientfrom % of charges | 1 | $4.8k | $4.8k | $989 | 20% | 2–20 | $3.9k – $5.8k |
| 12 | Inova Fairfax Hospital Falls Church, VA other · both | 1 | $7.7k | $7.7k | $1.5k | 20% | 2–20 | $6.2k – $9.2k |
| 13 | Northwestern Lake Forest Hospital Grayslake, IL case rate · outpatient | 2 | $5.7k | $5.7k | $299 | 5% | 2–20 | $5.4k – $6.0k |
| 14 | Northwestern Medicine Delnor Hospital Geneva, IL case rate · outpatient | 2 | $5.7k | $5.7k | $299 | 5% | 2–20 | $5.4k – $6.0k |
| 15 | Northwestern Memorial Hospital Chicago, IL case rate · outpatient | 2 | $4.3k | $4.3k | $224 | 5% | 2–20 | $4.0k – $4.5k |
| 16 | Palos Community Hospital Palos Heights, IL case rate · outpatient | 2 | $5.7k | $5.7k | $299 | 5% | 2–20 | $5.4k – $6.0k |
| 17 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 2 | $42.7k | $42.7k | — | — | 2–20 | $42.7k – $42.7k |
| 18 | Tufts Medical Center BOSTON, MA other · both | 2 | $12.0k | $12.0k | — | — | 2–20 | $12.0k – $12.0k |
| 19 | UNIVERSITY HEALTH SHREVEPORT, LLC Shreveport, LA case rate · outpatient | 1 | $2.2k | $2.4k | $1.1k | 45% | 2–20 | $680 – $4.0k |
| 20 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 3 | $6.8k | $7.0k | $2.7k | 38% | 2–20 | $3.9k – $11.6k |
| 21 | Blessing Hospital Quincy, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $939 | $939 | — | — | 1–10 | $939 – $939 |
| 22 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 2 | $1.6k | $1.6k | $933 | 60% | 1–10 | $621 – $2.5k |
| 23 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI other · outpatient | 1 | $671 | $671 | — | — | 1–10 | $671 – $671 |
| 24 | Henry Ford Health System Plymouth, MI facility · case rate · outpatient | 1 | $7.1k | $7.1k | — | — | 1–10 | $7.1k – $7.1k |
| 25 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.1k | $5.1k | — | — | 1–10 | $5.1k – $5.1k |
← Payers reporting CPT 67904 · Snapshot 20261112T181611Z-3fa9fb76