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Oasis Burn Matrix

Alaska rates for HCPCS Q4103

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

Rates data updated October 2026.

How much does Oasis Burn Matrix cost?

$23.44

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $23.44 for this service. The price depends on where it is billed: about $23.44 from a physician practice, and about $186 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$23.44$23.44 to $191
FacilityA hospital or hospital-owned outpatient department$186$23.99 to $316

How much rates vary

Facilitymedian $186 · 10th to 90th $21 to $550Professionalmedian $23 · 10th to 90th $15 to $339
$20$50$100$200$500$1Kfacility $186professional $23

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$23.44
Median
$23.44
Typical High
$23.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$23.44
Typical High
$23.44
Cigna
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$316.23
Typical High
$933.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$12.59
Median
$23.44
Typical High
$33.11
Moda Health
Setting
Professional
Modifier
None
Typical Low
$23.44
Median
$23.44
Typical High
$416.87
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$23.99
Typical High
$38.02
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$15.14
Typical High
$18.20
Providence
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$302.00
Typical High
$933.25
Providence
Setting
Professional
Modifier
None
Typical Low
$15.49
Median
$60.26
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$380.19

Where Alaska sits

The same service costs 10.0 times more in Illinois than in Pennsylvania. 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.

Alaska· 27th of 51

$23.44

IL $126PA $12.59

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.