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New York rates for HCPCS Q4142

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

Facilitymedian $138 · 10th–90th $95–$2190%50%10th90th$138Professionalmedian $117 · 10th–90th $45–$1450%50%10th90th$117$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $537.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $275.42
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $50,118.72 / $53,703.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $134.90