go back

HYALOMATRIX

Oregon rates for HCPCS Q4117

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

Rates data updated July 2026.

Facilitymedian $17 · 10th–90th $17$400%50%90th$17Professionalmedian $126 · 10th–90th $23$2750%20%10th90th$126$10.0$100.0$1.0K$10.0K$100.0K$1.0M

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
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$23.99
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$144.54
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$323.59
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$28.84
Typical High
$141.25
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$245.47
Typical High
$316.23
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Providence
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$32.36
Typical High
$251.19
Providence
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$79.43
Typical High
$125.89
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89