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Arizona rates for HCPCS Q4117

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

Facilitymedian $28 · 10th–90th $16–$1070%5%10%10th90th$28Professionalmedian $23 · 10th–90th $22–$1260%20%40%10th90th$23$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $26.92 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $23.99 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $23.99 / $50.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $33.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $125.89