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Minnesota rates for HCPCS Q4102

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

Facilitymedian $24 · 10th–90th $12–$420%20%10th90th$24Professionalmedian $102 · 10th–90th $10–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$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 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $23.99 / $23.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $36.31 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.45 / $15.49
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $36.31 / $45.71
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $13.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $11.75 / $25.70
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $16.22
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $125.89 / $239.88