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HYALOMATRIX

Utah 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?

$126

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $23.99 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$123 to $126
FacilityA hospital or hospital-owned outpatient department$23.99$23.99 to $151

How much rates vary

Facilitymedian $24 · 10th to 90th $24 to $158Professionalmedian $126 · 10th to 90th $24 to $145
$50$100$200$500facility $24professional $126

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Aetna
Setting
Professional
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Cigna
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$158.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$44.67
Typical High
$79.43
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$131.83
Typical High
$151.36
Select Health
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$120.23
Typical High
$151.36
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$169.82
Typical High
$295.12
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Utah 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.

Utah· 3rd of 51

$126

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.