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HYALOMATRIX

Maryland rates for HCPCS Q4117

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

Rates data updated July 2026.

Facilitymedian $25 · 10th–90th $25$250%50%$25Professionalmedian $25 · 10th–90th $19$1260%50%10th90th$25$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$24.55
Typical High
$24.55
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$13.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$138.04
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$134.90
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$162.18
Typical High
$204.17