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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
$707.95 / $707.95 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $831.76 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $776.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $1,148.15 / $1,348.96
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $11,481.54 / $27,542.29
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $891.25 / $1,318.26