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Connecticut rates for HCPCS Q4117

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

Facilitymedian $39 · 10th–90th $24–$2000%20%10th90th$39Professionalmedian $23 · 10th–90th $22–$340%50%10th90th$23$20.0$50.0$100.0$200.0

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
$23.99 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $24.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $24.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $120.23 / $125.89