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Nevada rates for HCPCS Q4102

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

Facilitymedian $380 · 10th–90th $11–$3800%50%10th$380Professionalmedian $12 · 10th–90th $11–$600%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
$10.96 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $12.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $36.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $128.82 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $125.89 / $141.25