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Tennessee 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
$0.87 / $0.99 / $1.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $1.04 / $1.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.69 / $4.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.43 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.91 / $10.03 / $12.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.81 / $0.99