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HYALOMATRIX

New Hampshire rates for HCPCS Q4117

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

Rates data updated July 2026.

How much does HYALOMATRIX cost?

$24.55

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $24.55 for this service. The price depends on where it is billed: about $24.55 from a physician practice, and about $29.51 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$24.55$16.98 to $24.55
FacilityA hospital or hospital-owned outpatient department$29.51$24.55 to $145

How much rates vary

Facilitymedian $30 · 10th to 90th $25 to $295Professionalmedian $25 · 10th to 90th $17 to $54
$20$50$100$200facility $30professional $25

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$24.55
Typical High
$34.67
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$28.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$37.15
Typical High
$125.89
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$38.90

Where New Hampshire sits

The same service costs 4.0 times more in Minnesota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 25th of 51

$24.55

MN $91.20KY $22.91

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.