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Rhode Island 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
$0.83 / $0.83 / $0.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.87 / $1.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $3.98 / $4.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.05 / $1.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $1.13 / $1.66