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Maine 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
Professional
Modifier
Low / Median / High Price
$0.60 / $1.14 / $1.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.85 / $0.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $1.63 / $1.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $1.14 / $1.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $1.00 / $2.29