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Hawaii rates for HCPCS A4402

Lubricant, per oz

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $0.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.44 / $4.44 / $4.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.53 / $1.53 / $6.15
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.59 / $5.85 / $5.85
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $5.59 / $7.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $4.44 / $6.15
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $4.65 / $5.32