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Massachusetts rates for HCPCS Q4117

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

Facilitymedian $32 · 10th–90th $24–$2240%20%10th90th$32Professionalmedian $23 · 10th–90th $17–$1260%20%40%10th90th$23$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $125.89 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $2,951.21
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $181.97 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $28.18
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $125.89 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $48.98 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $28.84 / $125.89