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Minnesota rates for HCPCS Q4117

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

Facilitymedian $37 · 10th–90th $23–$630%20%10th90th$37Professionalmedian $102 · 10th–90th $19–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$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
$28.18 / $28.18 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $37.15 / $46.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $50.12 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $20.42 / $21.88
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $51.29 / $64.57
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $19.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $38.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $39.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $125.89 / $239.88