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New Jersey rates for HCPCS Q4250

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $2,979.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.56 / $2,979.56 / $3,009.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,810.90 / $2,979.55 / $2,979.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,979.55 / $2,979.55 / $2,979.55
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,810.90 / $2,979.55 / $2,979.55
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
$2,863.13 / $2,863.13 / $2,863.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,855.38 / $2,979.56 / $3,143.44