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New Jersey rates for HCPCS Q4165

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.74 / $44.19 / $45.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.58 / $39.58 / $45.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.58 / $30.58 / $30.58
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,702.00 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.58 / $30.58 / $30.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.36 / $44.36 / $47.96