go back

New Jersey rates for HCPCS Q4239

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $1,902.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $1,921.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.81 / $373.76 / $1,902.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $2,153.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,884.68 / $1,902.62 / $2,430.34
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
$339.78 / $2,295.00 / $2,295.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,902.62 / $1,902.62 / $2,173.55