go back

Kentucky 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
$0.74 / $0.97 / $1.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.62 / $1.12 / $1.62
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.13 / $2.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.20 / $1.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.43 / $2.66 / $3.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $2.38 / $3.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.34 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.34 / $10.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.36 / $2.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.95 / $1.33