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Revitalon

Alaska rates for HCPCS Q4157

Revitalon, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Revitalon cost?

$209

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $214 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 6 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$204$174 to $302
FacilityA hospital or hospital-owned outpatient department$214$178 to $295

How much rates vary

Facilitymedian $214 · 10th to 90th $166 to $398Professionalmedian $204 · 10th to 90th $166 to $407
$100$200$500$1K$2Kfacility $214professional $204

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
Professional
Modifier
Global
Typical Low
$165.96
Median
$173.78
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$208.93
Typical High
$309.03
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$309.03
Typical High
$512.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$457.09
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$229.09
Typical High
$251.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$208.93
Typical High
$398.11
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$380.19

Where Alaska sits

The same service costs 1.5 times more in Alaska than in Minnesota. 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.

Alaska· 1st of 51

$209

AK $209MN $138

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.