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HYALOMATRIX

Indiana rates for HCPCS Q4117

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

Rates data updated October 2026.

How much does HYALOMATRIX cost?

$22.91

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $22.91 for this service. The price depends on where it is billed: about $22.91 from a physician practice, and about $204 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$22.91$16.98 to $126
FacilityA hospital or hospital-owned outpatient department$204$141 to $295

How much rates vary

Facilitymedian $204 · 10th to 90th $126 to $537Professionalmedian $23 · 10th to 90th $17 to $126
$20$50$100$200$500$1K$2Kfacility $204professional $23

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$22.91
Aetna
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$23.44
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$181.97
Typical High
$501.19
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$16.98
Typical High
$117.49
CareSource
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$354.81
Typical High
$588.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$229.09
Typical High
$346.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$616.60
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$912.01
Typical High
$2,137.96
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$19.50
Median
$125.89
Typical High
$234.42
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$173.78

Where Indiana sits

The same service costs 8.3 times more in North Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 50th of 51

$22.91

ND $141KY $16.98

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.