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Oasis Burn Matrix

Iowa 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?

$14.13

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $14.13 for this service. The price depends on where it is billed: about $15.14 from a physician practice, and about $12.59 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$15.14$12.30 to $126
FacilityA hospital or hospital-owned outpatient department$12.59$12.59 to $12.59

How much rates vary

Facilitymedian $13 · 10th to 90th $13 to $21Professionalmedian $15 · 10th to 90th $12 to $191
$10$100$1Kfacility $13professional $15

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$11.75
Median
$12.59
Typical High
$19.05
Aetna
Setting
Professional
Modifier
None
Typical Low
$11.75
Median
$11.75
Typical High
$12.59
Cigna
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$223.87
Typical High
$269.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$181.97
Typical High
$190.55
Hally Health
Setting
Professional
Modifier
None
Typical Low
$11.75
Median
$12.59
Typical High
$25.70
Medica
Setting
Facility
Modifier
None
Typical Low
$6.03
Median
$15.14
Typical High
$19.50
Medica
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.88
Typical High
$6,165.95
Midlands
Setting
Professional
Modifier
None
Typical Low
$15.85
Median
$190.55
Typical High
$190.55
Midlands
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$208.93
Typical High
$269.15
Midlands
Setting
Professional
Modifier
None
Typical Low
$10.00
Median
$15.85
Typical High
$18.62
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
Wellmark
Setting
Facility
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Wellmark
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$12.59

Where Iowa sits

The same service costs 10.0 times more in Oregon than in Virginia. 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.

Iowa· 38th of 51

$14.13

OR $126VA $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.