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Iowa rates for HCPCS Q4103

Oasis Burn Matrix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.38 / $18.69 / $18.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $12.49 / $12.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.05 / $10.05 / $10.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $15.04 / $16.23
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.78 / $12.49 / $22.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.78 / $15.00 / $19.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.38 / $12.38 / $24.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $15.04 / $18.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.88 / $15.04 / $18.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $14.20 / $15.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $12.49 / $16.25
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.38 / $12.38 / $12.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $12.38 / $12.38