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HYALOMATRIX

New York rates for HCPCS Q4117

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

Rates data updated October 2026.

How much does HYALOMATRIX cost?

$28.84

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $28.84 for this service. The price depends on where it is billed: about $28.84 from a physician practice, and about $30.20 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$28.84$24.55 to $126
FacilityA hospital or hospital-owned outpatient department$30.20$30.20 to $178

How much rates vary

Facilitymedian $30 · 10th to 90th $25 to $302Professionalmedian $29 · 10th to 90th $20 to $135
$20$50$100$200$500facility $30professional $29

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$22.91
Typical High
$24.55
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$22.91
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$186.21
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$24.55
Median
$138.04
Typical High
$501.19
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$24.55
Typical High
$34.67
Excellus BCBS
Setting
Facility
Modifier
None
Typical Low
$24.55
Median
$30.20
Typical High
$30.20
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$24.55
Median
$30.20
Typical High
$30.20
MVP Health Care
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$24.55
Typical High
$24.55
United
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$125.89
Typical High
$165.96
Univera
Setting
Facility
Modifier
None
Typical Low
$24.55
Median
$30.20
Typical High
$30.20
Univera
Setting
Professional
Modifier
None
Typical Low
$24.55
Median
$30.20
Typical High
$30.20

Where New York sits

The same service costs 8.3 times more in North Dakota 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 York· 31st of 51

$28.84

ND $141KY $16.98

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.