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Cygnus Matrix

Ohio rates for HCPCS Q4199

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

Rates data updated July 2026.

Facilitymedian $129 · 10th–90th $102$3550%20%10th90th$129Professionalmedian $115 · 10th–90th $112$1820%50%10th90th$115$2.0$10.0$50.0$200.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$234.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
CareSource
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$389.05
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$102.33
Typical High
$154.88
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$141.25
Typical High
$158.49
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90