go back

Georgia rates for HCPCS Q4102

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $11.75 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.22 / $11.22 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $14.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $128.82 / $186.21
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $21.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $23.44 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $36.31 / $125.89