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Massachusetts rates for HCPCS Q4102

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

Facilitymedian $34 · 10th–90th $11–$1620%20%10th90th$34Professionalmedian $12 · 10th–90th $11–$1070%50%10th90th$12$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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 / $16.22
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.55 / $25.70 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $125.89 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $173.78 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $19.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.55 / $25.70 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $125.89 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $19.95 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.88 / $125.89