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New York rates for HCPCS Q4102

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

Facilitymedian $12 · 10th–90th $11–$1860%20%40%10th90th$12Professionalmedian $13 · 10th–90th $11–$390%20%10th90th$13$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $15.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $10.23
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $138.04 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $125.89 / $125.89
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $138.04 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $199.53
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $12.30
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.30 / $12.30
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $13.18 / $125.89
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $13.18
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.30 / $12.30