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Oasis Wound Matrix

South Dakota 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?

$12.30

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $12.30 for this service. The price depends on where it is billed: about $12.30 from a physician practice, and about $11.75 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$12.30$11.75 to $14.79
FacilityA hospital or hospital-owned outpatient department$11.75$11.75 to $14.13

How much rates vary

Facilitymedian $12 · 10th to 90th $12 to $20Professionalmedian $12 · 10th to 90th $12 to $25
$10$20$50$100$200$500$1Kfacility $12professional $12

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
$11.75
Typical High
$13.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$14.79
Avera
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.30
Typical High
$12.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$16.22
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$14.13
Typical High
$15.14
Medica
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$19.95
Typical High
$23.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$1,584.89
Midlands
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$14.45
Midlands
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$169.82
Typical High
$204.17
Midlands
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$24.55
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$13.49
Typical High
$13.49
United
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$125.89
Typical High
$239.88
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75

Where South Dakota sits

The same service costs 5.1 times more in Minnesota than in Tennessee. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 29th of 51

$12.30

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.