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Oasis Burn Matrix

Idaho 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?

$126

Typical negotiated rate. In Idaho, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $145 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$15.49 to $151
FacilityA hospital or hospital-owned outpatient department$145$12.59 to $158

How much rates vary

Facilitymedian $145 · 10th to 90th $8 to $191Professionalmedian $126 · 10th to 90th $14 to $204
$2$5$10$20$50$100$200facility $145professional $126

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
Professional
Modifier
None
Typical Low
$13.80
Median
$15.49
Typical High
$15.49
BCBS Idaho
Setting
Facility
Modifier
None
Typical Low
$1.86
Median
$9.55
Typical High
$15.85
BCBS Idaho
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$151.36
BCBS Idaho
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$158.49
Median
$177.83
Typical High
$186.21
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$158.49
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$12.59
Median
$15.49
Typical High
$22.39
Moda Health
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$15.49
Typical High
$223.87
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$194.98
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$204.17
Select Health
Setting
Facility
Modifier
None
Typical Low
$9.33
Median
$117.49
Typical High
$120.23
Select Health
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$154.88
Typical High
$213.80
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Idaho 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.

Idaho· 10th of 51

$126

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.