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Cygnus Matrix

Washington rates for HCPCS Q4199

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

Rates data updated July 2026.

Facilitymedian $195 · 10th–90th $112$7760%20%10th90th$195Professionalmedian $123 · 10th–90th $112$1950%50%10th90th$123$50.0$100.0$200.0$500.0$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
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$158.49
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$630.96
Typical High
$912.01
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$724.44
Typical High
$912.01
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$60.26
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$125.89
Typical High
$165.96
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$389.05
Typical High
$389.05
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$194.98
Typical High
$194.98
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$363.08