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Oasis Burn Matrix

Washington, DC rates for HCPCS Q4103

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

Rates data updated July 2026.

Facilitymedian $13 · 10th–90th $13$2630%50%90th$13Professionalmedian $13 · 10th–90th $13$1260%50%90th$13$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$12.88
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$16.98
Typical High
$32.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$263.03
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$14.45
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$125.89
Typical High
$158.49