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Connecticut rates for HCPCS Q4102

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

Facilitymedian $34 · 10th–90th $12–$1450%50%10th90th$34Professionalmedian $12 · 10th–90th $11–$310%20%40%10th90th$12$10.0$20.0$50.0$100.0$200.0

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
$12.02 / $33.11 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $30.90 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $14.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $14.13 / $125.89