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South Carolina rates for HCPCS A4402

Lubricant, per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $1.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.34 / $2.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.35 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $2.57
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.45 / $1.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.17 / $1.95 / $3.63
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.62 / $0.62 / $0.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.87 / $1.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $1.07 / $1.45