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Colorado rates for HCPCS Q4103

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

Facilitymedian $38 · 10th–90th $12–$1450%20%10th90th$38Professionalmedian $12 · 10th–90th $12–$580%50%90th$12$2.0$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 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $13.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $144.54 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $190.55 / $213.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $125.89 / $125.89