go back

Massachusetts rates for HCPCS Q4199

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.15 / $111.15 / $111.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $115.60
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.15 / $362.57 / $1,606.18
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $1,606.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.15 / $111.15 / $111.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $111.15
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.15 / $167.00 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.82 / $479.82 / $564.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $111.15
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.00 / $474.00 / $1,606.18
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $1,606.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.15 / $111.15 / $270.08