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New Jersey rates for HCPCS Q4195

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $98.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.39 / $97.94 / $107.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $110.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.40 / $97.94 / $145.30
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
$102.09 / $102.79 / $126.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $111.89