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XCM Biologic Tissue Matrix

Connecticut rates for HCPCS Q4142

XCM biologic tissue matrix, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does XCM Biologic Tissue Matrix cost?

$117

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $145 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 5 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$117$91.20 to $126
FacilityA hospital or hospital-owned outpatient department$145$91.20 to $145

How much rates vary

Facilitymedian $145 · 10th to 90th $91 to $245Professionalmedian $117 · 10th to 90th $81 to $135
$100$1K$10Kfacility $145professional $117

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
$91.20
Median
$91.20
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$117.49
Typical High
$134.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$125.89
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$144.54
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$173.78
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$125.89
Typical High
$50,118.72

Where Connecticut sits

The same service costs 1.7 times more in Alaska 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.

Connecticut· 44th of 51

$117

AK $141KY $81.28

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.