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Vermont 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 / $1.45 / $1.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
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 / $1.44
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.34 / $1.34
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $1.34 / $1.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $1.30 / $2.48