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XCM Biologic Tissue Matrix

New Jersey 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 $138 · 10th–90th $126$3160%50%10th90th$138Professionalmedian $126 · 10th–90th $81$1480%50%10th90th$126$50.0$200.0$1.0K$5.0K$20.0K$100.0K$500.0K

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
$138.04
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$162.18
Typical High
$239.88
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$426.58
Typical High
$562.34
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$125.89
Typical High
$134.90