go back

Alaska rates for HCPCS A4402

Lubricant, per oz

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $5.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.34 / $1.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.61 / $0.61
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $4.99 / $7.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $1.95 / $5.13
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $5.13 / $10.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.61 / $1.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.34 / $3.74 / $6.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.62 / $5.03