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Matrion

Montana rates for HCPCS Q4201

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

Rates data updated July 2026.

Facilitymedian $182 · 10th–90th $89$2140%50%10th90th$182Professionalmedian $83 · 10th–90th $76$1910%20%10th90th$83$100.0$200.0$500.0

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
Professional
Modifier
Global
Typical Low
$75.86
Median
$83.18
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$181.97
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$213.80
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$213.80
Providence
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$309.03
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$97.72
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89