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Matrion

Michigan rates for HCPCS Q4201

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

Rates data updated July 2026.

Facilitymedian $102 · 10th–90th $78$3550%20%40%10th90th$102Professionalmedian $78 · 10th–90th $76$1260%50%10th90th$78$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
$77.62
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$79.43
BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$125.89
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$354.81
Typical High
$954.99
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$138.04
Typical High
$457.09
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$93.33
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83