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New Jersey rates for HCPCS Q4221

Amnio Wrap2, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $1,961.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $1,980.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,850.00 / $1,961.00 / $1,961.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $2,220.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,850.00 / $1,961.00 / $2,504.90
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
$1,696.00 / $2,014.00 / $2,014.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $2,157.10