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Texas 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
$0.84 / $1.11 / $1.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $1.11 / $1.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.27 / $1.78 / $4.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.81 / $0.81
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $1.27 / $1.27
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.52 / $5.52 / $5.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $1.20 / $2.19
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.34 / $2.12
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.61 / $1.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $2.60 / $3.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.35 / $2.29
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.92 / $1.22
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $1.69 / $2.27