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Arkansas rates for HCPCS Q4103

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

Facilitymedian $13 · 10th–90th $13–$140%50%90th$13Professionalmedian $12 · 10th–90th $12–$170%50%90th$12$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
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $173.78 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $125.89 / $125.89