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Oasis Wound Matrix

Utah 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?

$13.80

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $13.80 for this service. The price depends on where it is billed: about $13.18 from a physician practice, and about $13.80 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 7 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$13.18$12.02 to $83.18
FacilityA hospital or hospital-owned outpatient department$13.80$13.80 to $15.85

How much rates vary

Facilitymedian $14 · 10th to 90th $14 to $120Professionalmedian $13 · 10th to 90th $12 to $126
$10.0$20.0$50.0$100.0$200.0$500.0facility $14professional $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
$13.80
Median
$13.80
Typical High
$13.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$12.88
Typical High
$14.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$16.98
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$15.14
Typical High
$75.86
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$131.83
Typical High
$162.18
Select Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$120.23
Typical High
$144.54
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$169.82
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Utah 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.

Utah $13.80 · 10th 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.