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California rates for HCPCS A4455

Adhesive Remover Or Solvent (For Tape Cement Or Other Adhesive) Per Ounce (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.59 / $5.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.74 / $5.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.62 / $0.74 / $1.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.85 / $7.27
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.10 / $2.95 / $4.23
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $5.05 / $7.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.19 / $2.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.19 / $2.49 / $4.58
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.43 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.91 / $10.03 / $12.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.29 / $0.29 / $0.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.99 / $2.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $2.10
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.76 / $3.76 / $3.76
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.27 / $1.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.90 / $2.67