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Oklahoma rates for HCPCS Q4102

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

Facilitymedian $13 · 10th–90th $12–$1000%20%10th90th$13Professionalmedian $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
$12.02 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $331.13 / $363.08
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
$10.47 / $13.18 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.75 / $17.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $19.95 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $125.89 / $125.89