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Missouri rates for HCPCS Q4102

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

Facilitymedian $14 · 10th–90th $12–$1020%20%10th90th$14Professionalmedian $12 · 10th–90th $11–$1260%20%10th90th$12$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 / $12.02 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $11.75 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $97.72 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $14.45 / $38.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $11.75 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $17.38 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $125.89 / $125.89