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
Ozark, MO
See all hospitals reporting CPT 67904 →Price type
Mercy Hospital Springfield’s median price of $2.3k is 14% below the median hospital's median price ($2.7k), higher than 33% 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: 13 payers, 28 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 | Medicaid hb sprg/jopl ark medicaid facility · fee schedule · outpatient | $320 | $320 | — | — | — | $320 – $320 |
| 2 | Blue Cross Blue Shield hb sprg medicare facility · fee schedule · outpatient | $469 | $469 | — | — | — | $469 – $469 |
| 3 | Blue Cross Blue Shield hb sprg kancare healthy blue medicaid facility · fee schedule · outpatient | $757 | $757 | — | — | — | $757 – $757 |
| 4 | Aetna hb sprg ok medicaid facility · fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 5 | Humana hb sprg ok medicaid facility · fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 6 | Medicaid hb sprg ok medicaid facility · fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 7 | MultiPlan hb sprg phcs (mpi) facility · fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 8 | Aetna hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 9 | Blue Cross Blue Shield hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 10 | Cigna hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 11 | Humana hb sprg humana medicare 100% facility · other · outpatient | $2.3k | $2.3k | — | — | 1–10 | $2.3k – $2.3k |
| 12 | Medica hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 13 | Medicare hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 14 | Tricare hb sprg tricare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 15 | UnitedHealthcare hb sprg medicare facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 16 | UnitedHealthcare hb sprg uhc mcr 100% facility · other · outpatient | $2.3k | $2.3k | — | — | 11 | $2.3k – $2.3k |
| 17 | WellCare hb sprg & lebn wellcare mcr 103% facility · other · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 18 | Devoted hb sprg devoted health medicare advantage 104% w/seq facility · other · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 19 | Humana hb sprg humana facility · fee schedule · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 20 | Blue Cross Blue Shield hb sprg missouri care plan/healthy blue facility · fee schedule · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 21 | Medicaid hb sprg mo medicaid facility · fee schedule · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 22 | UnitedHealthcare hb sprg uhc all payer facility · other · outpatient | $3.5k | $3.5k | — | — | 1–10 | $3.5k – $3.5k |
| 23 | Blue Cross Blue Shield hb sprg anthem pathways exchange facility · case rate · outpatient | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 24 | UnitedHealthcare hb sprg uhc mo medicaid facility · fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 25 | Anthem hb sprg anthem alliance facility · case rate · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
Last updated: Jun 4, 2026
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