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New Jersey rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $93.33 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $186.21 / $245.47
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $112.20 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $275.42