go back

New Jersey rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.69 / $8.69 / $8.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.23 / $8.69 / $14.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $7.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.72 / $23.36 / $31.20
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.82 / $14.82 / $14.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.02 / $8.89 / $11.27