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
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL
Quincy, IL
See all hospitals reporting CPT 67904 →Price type
Blessing Hospital’s median price of $1.1k is 59% below the median hospital's median price ($2.7k), higher than 15% of the 1,685 hospitals reporting CPT 67904. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna commercial professional · case rate · both | $501 | $501 | — | — | — | $501 – $501 |
| 2 | UnitedHealthcare medicare advantage professional · case rate · both | $501 | $501 | — | — | — | $501 – $501 |
| 3 | UnitedHealthcare commercial professional · fee schedule · both | $676 | $676 | — | — | — | $676 – $676 |
| 4 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $939 | $939 | — | — | 1–10 | $939 – $939 |
| 5 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $956 | $956 | — | — | — | $956 – $956 |
| 6 | Bcbs Il commercial facility · percent of total billed charges · inpatientfrom % of charges | $957 | $957 | — | — | — | $957 – $957 |
| 7 | Bcbs Il commercial facility · percent of total billed charges · outpatientfrom % of charges | $957 | $957 | — | — | — | $957 – $957 |
| 8 | Blue Cross Blue Shield commercial professional · fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 9 | Bcbs Mo commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Bcbs Mo commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 11 | Blue Cross Blue Shield commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 12 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 13 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 14 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 15 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 16 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 17 | Humana commercial facility · percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | Humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | Humana commercial professional · percent of total billed charges · bothfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 20 | Cigna commercial professional · percent of total billed charges · bothfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 21 | Bcbs Il commercial professional · fee schedule · both | $1.6k | $1.6k | $163 | 10% | — | $1.4k – $1.8k |
| 22 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
Last updated: Jun 8, 2026
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