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
$11.70 / $11.88 / $11.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $13.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $12.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.88 / $11.88 / $23.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.21 / $11.21 / $11.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $15.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.07 / $12.07 / $24.14
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.20 / $21.99 / $239.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $15.64