go back

New Hampshire rates for HCPCS Q4102

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

Facilitymedian $14 · 10th–90th $4–$2510%20%10th90th$14Professionalmedian $12 · 10th–90th $11–$350%20%40%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
$11.75 / $14.13 / $131.83
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
$30.20 / $30.90 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $21.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $12.59 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.89 / $43.65