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Oregon 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
$0.66 / $1.26 / $6.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $1.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $1.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $4.25 / $5.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.60 / $1.96 / $2.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $1.85 / $2.34
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.90 / $2.18 / $2.45
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.23 / $2.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.13 / $1.90 / $2.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.95 / $2.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $2.45 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $0.95 / $1.82