go back

New Jersey rates for HCPCS Q4115

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.86 / $12.86 / $12.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $12.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.71 / $14.43 / $16.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $12.86
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $15.89
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.38 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.13 / $12.38 / $12.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $13.57