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New Jersey rates for HCPCS Q4253

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

Facilitymedian $692 · 10th–90th $76–$23,9880%10%10th90th$692Professionalmedian $76 · 10th–90th $71–$1260%50%10th90th$76$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $831.76 / $977.24
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $11,481.54 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $660.69 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $213.80