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California rates for HCPCS Q4102

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

Facilitymedian $39 · 10th–90th $30$1660%50%10th90th$39Professionalmedian $12 · 10th–90th $11$1350%20%40%10th90th$12$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $60.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $38.90 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $30.90 / $45.71
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $14.79 / $27.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $5.13 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $177.83 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $269.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $10.72 / $12.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $12.59 / $194.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $125.89 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $14.79 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $125.89 / $147.91