go back

Revitalon

Virginia 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 Virginia, 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 $191 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 8 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$166 to $178
FacilityA hospital or hospital-owned outpatient department$191$178 to $214

How much rates vary

Facilitymedian $191 · 10th to 90th $170 to $282Professionalmedian $174 · 10th to 90th $126 to $209
$200$500facility $191professional $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
$177.83
Median
$177.83
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$177.83
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$316.23
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$239.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$204.17
Typical High
$281.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$208.93
Typical High
$208.93
Sentara
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$199.53
Typical High
$257.04
Sentara
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$199.53
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Virginia 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.

Virginia· 21st 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.