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Alaska rates for HCPCS Q4102

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

Facilitymedian $15 · 10th–90th $12–$1450%20%10th90th$15Professionalmedian $12 · 10th–90th $11–$2950%20%10th90th$12$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $11.22 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $13.18 / $31.62
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $295.12 / $489.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $19.05 / $38.02
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $14.79 / $16.22
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $14.13 / $144.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $60.26 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $323.59