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Kentucky rates for HCPCS Q4102

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

Facilitymedian $14 · 10th–90th $13–$140%50%10th$14Professionalmedian $12 · 10th–90th $11–$200%20%40%10th90th$12$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $12.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $14.13 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $14.45
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $19.05
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.59 / $16.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $125.89 / $125.89