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Colorado rates for HCPCS A4402

Lubricant Per Ounce (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $0.96 / $0.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.62 / $0.96 / $1.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.11 / $1.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.34 / $1.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $2.29
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $1.09 / $2.79
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $0.61 / $0.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $2.79 / $4.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.95 / $1.36