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Revitalon

Georgia 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?

$174

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $174 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$174$170 to $191
FacilityA hospital or hospital-owned outpatient department$174$174 to $245

How much rates vary

Facilitymedian $174 · 10th to 90th $141 to $339Professionalmedian $174 · 10th to 90th $126 to $195
$100$200facility $174professional $174

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
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$173.78
Typical High
$208.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$190.55
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$234.42
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$162.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$204.17
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$245.47
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$177.83

Where Georgia 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.

Georgia· 16th of 51

$174

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.