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New York rates for HCPCS Q4117

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.80 / $24.39 / $24.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.80 / $23.53 / $24.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.97 / $28.69 / $28.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.37 / $24.39 / $25.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.35 / $27.13 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.55 / $24.38 / $27.93
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.38 / $30.40 / $30.40
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.38 / $24.38 / $30.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.98 / $261.98 / $261.98
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.39 / $24.66 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $28.69 / $40.20
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.38 / $24.38 / $24.38
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.38 / $24.38 / $30.40