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New Jersey rates for HCPCS Q4124

OASIS ultra tri-layer wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $2,089 · 10th–90th $3–$20,4170%5%10th90th$2,089Professionalmedian $2 · 10th–90th $2–$1260%50%90th$2$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $3.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $3.80 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $208.93
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $9,332.54 / $23,988.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $13.18 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $16.98 / $125.89