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HYALOMATRIX

Hawaii rates for HCPCS Q4117

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

Rates data updated July 2026.

Professionalmedian $24 · 10th–90th $23$1450%50%10th90th$24$10.0$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
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$23.99
Typical High
$24.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$125.89
Typical High
$125.89
HMSA
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$30.90
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$173.78
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$125.89
Typical High
$125.89