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HYALOMATRIX

Arizona rates for HCPCS Q4117

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

Rates data updated July 2026.

Facilitymedian $89 · 10th–90th $24$2690%5%10th90th$89Professionalmedian $24 · 10th–90th $23$1260%50%10th90th$24$20.0$50.0$100.0$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$23.44
Typical High
$23.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$23.99
Typical High
$24.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$97.72
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$23.99
Typical High
$50.12
Medica
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$33.88
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89