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Wyoming 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
$0.96 / $0.96 / $1.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.34 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $1.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.95 / $1.05