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Arizona rates for HCPCS Q4102

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

Facilitymedian $21 · 10th–90th $12–$2090%10%20%10th90th$21Professionalmedian $12 · 10th–90th $11–$1260%20%10th90th$12$5.0$20.0$100.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $21.88 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $16.22
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $19.50 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $16.98 / $29.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $13.18 / $25.70
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $13.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $125.89 / $125.89