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New Jersey rates for HCPCS Q4117

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.80 / $23.81 / $24.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.19 / $13.20 / $24.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.55 / $24.38 / $24.38
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.80 / $8,702.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $24.38 / $24.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $30.27