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Washington rates for HCPCS A4455

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

Facilitymedian $2 · 10th–90th $2–$40%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$30%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $1.02
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.95 / $4.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $3.02 / $4.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.70 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $1.95 / $2.00
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.19
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $3.09 / $3.80
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.74 / $2.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.66 / $1.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.78 / $0.85 / $1.62
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $3.02