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New Jersey rates for HCPCS Q4126

MemoDerm, DermaSpan, TranZgraft or InteguPly, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $1,778 · 10th–90th $63–$20,4170%5%10th90th$1,778Professionalmedian $63 · 10th–90th $62–$1260%20%40%10th90th$63$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
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $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
$70.79 / $83.18 / $218.78
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $8,709.64 / $23,988.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $109.65 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $107.15 / $125.89