go back

Alaska rates for HCPCS Q4117

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

Facilitymedian $32 · 10th–90th $17–$1580%10%10th90th$32Professionalmedian $24 · 10th–90th $22–$3020%20%40%10th90th$24$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $29.51 / $158.49
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $302.00 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $3,467.37
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $31.62 / $34.67
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $31.62 / $158.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $316.23