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New Jersey rates for HCPCS Q4259

Celera Dual Layer or Celera Dual Membrane, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.50 / $713.50 / $713.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.50 / $713.50 / $720.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.50 / $969.00 / $1,254.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.50 / $713.50 / $807.74
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.11 / $713.50 / $1,058.46
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
$975.26 / $975.26 / $997.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.50 / $713.50 / $771.44