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Michigan rates for HCPCS Q4117

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

Facilitymedian $28 · 10th–90th $22–$1020%20%40%10th90th$28Professionalmedian $23 · 10th–90th $22–$340%20%40%10th90th$23$5.0$10.0$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. 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 / $24.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.68 / $27.54 / $27.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $27.54 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $125.89 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $30.20 / $81.28
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $30.20 / $138.04
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $125.89