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Maryland rates for HCPCS A4257

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.96 / $15.85
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $19.95 / $27.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $18.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $8.91 / $13.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $10.96