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Oasis Wound Matrix

Ohio rates for HCPCS Q4102

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

Rates data updated July 2026.

How much does Oasis Wound Matrix cost?

$12.59

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $12.59 for this service. The price depends on where it is billed: about $12.59 from a physician practice, and about $34.67 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.59$11.75 to $28.84
FacilityA hospital or hospital-owned outpatient department$34.67$11.75 to $240

How much rates vary

Facilitymedian $35 · 10th to 90th $12 to $275Professionalmedian $13 · 10th to 90th $12 to $126
$2.0$10.0$50.0$200.0facility $35professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$13.80
Typical High
$34.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$13.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$15.14
Typical High
$63.10
CareSource
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
CareSource
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$16.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$389.05
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$91.20
Typical High
$131.83
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$141.25
Typical High
$158.49
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$35.48
Typical High
$74.13
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$125.89
Typical High
$125.89

Where Ohio sits

The same service costs 5.1 times more in Minnesota than in Tennessee. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Ohio $12.59 · 17th of 51
MN $60.26TN $11.75

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.