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Pennsylvania rates for HCPCS A4455

Adhesive remover or solvent (for tape, cement or other adhesive), per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $0.96 / $1.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.20 / $1.52
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.00 / $57,255.43 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $1.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $2.29 / $2.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $0.96 / $1.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.20 / $1.64
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $2.80 / $3.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.40 / $1.47 / $1.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.86 / $1.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.99 / $1.76