go back

Washington rates for HCPCS A0422

Ambulance (ALS or BLS) oxygen and oxygen supplies, life sustaining situation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.10 / $34.85 / $34.85
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $145.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.55 / $22.55 / $34.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.10 / $54.17 / $54.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.44 / $35.26 / $42.21