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Matrion

Washington rates for HCPCS Q4201

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

Rates data updated July 2026.

Facilitymedian $83 · 10th–90th $76$5620%20%10th90th$83Professionalmedian $83 · 10th–90th $76$1480%20%10th90th$83$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
$83.18
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$77.62
Typical High
$147.91
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
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$467.74
Typical High
$645.65
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$223.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$50.12
Typical High
$60.26
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$114.82
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$275.42
Typical High
$275.42
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$120.23
Typical High
$120.23
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
$85.11
Median
$154.88
Typical High
$295.12