go back

Rhode Island 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
$0.62 / $0.79 / $1.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.68 / $3.62 / $4.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.00 / $1.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.34 / $1.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $1.13 / $1.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.95 / $1.58