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Kentucky rates for HCPCS Q4117

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

Facilitymedian $46 · 10th–90th $22–$4070%20%10th90th$46Professionalmedian $22 · 10th–90th $17–$320%20%10th90th$22$10.0$20.0$50.0$100.0$200.0$500.0

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 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $22.91
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $467.74
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $309.03 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $213.80 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $125.89 / $125.89