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New Jersey rates for HCPCS Q4111

GammaGraft, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.87 / $7.87 / $7.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $7.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.28 / $8.26 / $10.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $7.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.88 / $8.53 / $8.53
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.60 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.60 / $7.60 / $8.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $8.35