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Florida 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
$0.89 / $1.12 / $1.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.31 / $1.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $1.72 / $80.00
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 / $1.38
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $5.20 / $8.72
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.50 / $1.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.45 / $1.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.95 / $1.28
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.73