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South Carolina rates for HCPCS Q4102

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

Facilitymedian $15 · 10th–90th $12–$1740%20%10th90th$15Professionalmedian $12 · 10th–90th $11–$1150%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
$12.02 / $16.60 / $16.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $11.75 / $12.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $7.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $13.49 / $26.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $125.89 / $125.89