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California rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.78 / $5.23 / $51.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $8.32 / $51.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.59 / $6.66 / $11.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $7.65 / $16.57
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.71 / $26.28 / $37.67
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.73 / $45.05 / $67.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $7.28
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.82 / $19.61 / $24.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $22.29 / $41.01
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.19 / $83.77 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.79 / $88.79 / $133.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.55 / $36.55 / $36.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.75 / $17.82 / $24.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $18.87
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.64 / $33.64 / $33.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $7.56 / $19.97