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Illinois 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
$0.97 / $0.97 / $1.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.98 / $1.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $7.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.30 / $1.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.39
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $2.15 / $11.87
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $2.42 / $2.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.87 / $1.54