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
Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl
Eureka, IL
See all hospitals reporting CPT 67904 →Price type
Carle Eureka Hospital’s median price of $1.6k is 40% below the median hospital's median price ($2.7k), higher than 19% of the 1,676 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: 9 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 | Cigna ppo case rate · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $590 | $590 | — | — | — | $590 – $590 |
| 3 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $590 | $590 | — | — | — | $590 – $590 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $608 | $608 | — | — | — | $608 – $608 |
| 5 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $608 | $608 | — | — | — | $608 – $608 |
| 6 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $732 | $732 | — | — | — | $732 – $732 |
| 7 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $732 | $732 | — | — | — | $732 – $732 |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $732 | $732 | — | — | — | $732 – $732 |
| 9 | Aetna commercial fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 12 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 13 | UnitedHealthcare va ccn/optum percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 14 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 15 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 16 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 17 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 18 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 19 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 20 | WellCare medicare advantage hmo case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 21 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 22 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
Last updated: Apr 15, 2026
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