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New Jersey rates for HCPCS L4130

Replace Pretibial Shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.28 / $190.28 / $190.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.28 / $259.18 / $335.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.45 / $373.57 / $558.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $272.70 / $489.42
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.63 / $514.22 / $732.21
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.42 / $532.00 / $558.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.55 / $276.36 / $558.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.03 / $278.85 / $513.13