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XCM Biologic Tissue Matrix

Mississippi 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.

Facilitymedian $126 · 10th–90th $81$1350%20%40%10th90th$126Professionalmedian $98 · 10th–90th $81$1290%20%10th90th$98$2.0$5.0$10.0$20.0$50.0$100.0$200.0

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
$81.28
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$128.82
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$25.12
Typical High
$50.12
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$128.82