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Iowa rates for HCPCS Q4117

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

Facilitymedian $29 · 10th–90th $29–$290%50%$29Professionalmedian $23 · 10th–90th $22–$760%50%10th90th$23$0.1$0.2$1.0$5.0$20.0$100.0

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
$21.88 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $21.38 / $50.12
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $33.11 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $27.54 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $28.84 / $50.12
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $23.44 / $28.84
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $26.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $28.84 / $48.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $131.83
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84