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New Jersey rates for HCPCS Q4157

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

Facilitymedian $2,089 · 10th–90th $158–$20,4170%10%10th90th$2,089Professionalmedian $174 · 10th–90th $135–$1780%50%10th90th$174$100.0$500.0$2.0K$10.0K

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
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $177.83 / $194.98
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
$151.36 / $177.83 / $229.09
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
$162.18 / $162.18 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $288.40 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $134.90 / $204.17