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Oregon rates for HCPCS Q4102

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

Facilitymedian $12 · 10th–90th $12–$210%50%90th$12Professionalmedian $13 · 10th–90th $11–$2570%20%40%10th90th$13$5.0$50.0$500.0$5.0K$50.0K$500.0K

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 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.02 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $23.99 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $257.04 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $13.80 / $141.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $239.88 / $316.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $13.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $13.49 / $134.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $79.43 / $125.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89