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Ohio rates for HCPCS A4928

Surgical mask, per 20

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.16
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
$1.00 / $1.08 / $1.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.20 / $16.20 / $19.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.25 / $20.25 / $21.06
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
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $17.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00