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New Jersey rates for HCPCS Q4122

Dermacell Dermacell Awm Or Dermacell Awm Porous Per Square Centimeter (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.85 / $102.85 / $102.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.49 / $100.43 / $102.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.85 / $112.20 / $145.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.85 / $102.85 / $102.85
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.85 / $108.90 / $108.90
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.43 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.85 / $102.85 / $102.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.00 / $110.00 / $118.93