go back

South Carolina 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
$1.57 / $1.57 / $1.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $1.48 / $1.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $2.04 / $3.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $1.20 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.96 / $3.71
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,000.00 / $3,000.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.89 / $1.12