go back

Idaho rates for HCPCS A4928

Surgical mask, per 20

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $17.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.28 / $1.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,500.00