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Michigan rates for HCPCS Q4102

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

Facilitymedian $16 · 10th–90th $12–$1020%20%40%10th90th$16Professionalmedian $12 · 10th–90th $11–$320%20%10th90th$12$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
$12.02 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $13.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $32.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $30.90 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $16.60 / $44.67
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $16.60 / $138.04
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $125.89 / $125.89