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Missouri rates for HCPCS Q4117

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

Facilitymedian $31 · 10th–90th $22$1450%10%10th90th$31Professionalmedian $24 · 10th–90th $22$1260%20%10th90th$24$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 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $109.65 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $28.84 / $64.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $28.84 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $43.65 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $125.89 / $125.89