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Idaho rates for HCPCS A4402

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $1.91 / $2.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $1.53
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $1.53 / $2.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.95 / $2.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.44 / $3.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $1.42 / $2.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.90 / $1.51