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Mississippi 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
$1.58 / $1.58 / $1.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $1.58 / $1.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.54 / $1.54 / $1.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.47 / $1.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.34 / $1.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $1.13 / $1.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.88 / $2.04