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Idaho rates for HCPCS Q4102

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

Facilitymedian $15 · 10th–90th $9–$1410%10%10th90th$15Professionalmedian $13 · 10th–90th $11–$1580%20%10th90th$13$5.0$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
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $15.85
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $10.96 / $21.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $13.49 / $33.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $208.93 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $10.47 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $125.89 / $125.89