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
Hackensack, NJ
See all hospitals reporting CPT 67904 →Price type
Hmh Hospitals Corporation’s median price of $5.5k is 102% above the median hospital's median price ($2.7k), higher than 86% 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: 8 payers, 18 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 | Clover medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
| 2 | Optum managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 3 | Aetna managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 4 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | 1–10 | $2.0k – $2.0k |
| 5 | Optum managed medicaid facility · fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 6 | Aetna medicare advantage facility · fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 7 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 8 | Optum medicare advantage facility · fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 9 | WellCare managed medicaid facility · fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 10 | WellCare medicare advantage facility · fee schedule · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 11 | Cigna bh facility · percent of total billed charges · outpatientfrom % of charges | $5.3k | $5.3k | — | — | — | $5.3k – $5.3k |
| 12 | MultiPlan all products facility · percent of total billed charges · outpatientfrom % of charges | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 13 | Cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 14 | Cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 15 | Aetna asa facility · case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 16 | Aetna hmo facility · case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 17 | Aetna ppo facility · case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 18 | UnitedHealthcare hmo facility · case rate · outpatient | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
Last updated: Dec 31, 2025
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