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Kentucky rates for HCPCS A4928

Surgical mask, per 20

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.00 / $1.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.20 / $21.87 / $28.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $20.25 / $25.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $17.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.60 / $3,000.00