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Florida rates for HCPCS Q4117

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

Facilitymedian $24 · 10th–90th $23–$1860%50%10th90th$24Professionalmedian $24 · 10th–90th $22–$1260%50%10th90th$24$0.5$2.0$10.0$50.0$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
$22.91 / $22.91 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $26.30
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $107.15 / $125.89
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $107.15 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $91.20 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $128.82