go back

Louisiana 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 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $12.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $12.59 / $12.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $12.59 / $12.59
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $120.23
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 / $11.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $12.02 / $14.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $30.20 / $125.89