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Massachusetts rates for HCPCS A4402

Lubricant, per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $3.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.80
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $1.95 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.45 / $1.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.23 / $3.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.35 / $1.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.35 / $1.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.66 / $2.51
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.58 / $1.95 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.48 / $2.14
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.23 / $1.23 / $1.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.89 / $1.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.12 / $1.66