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Louisiana rates for HCPCS Q4103

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

Facilitymedian $13 · 10th–90th $12–$1020%50%10th90th$13Professionalmedian $12 · 10th–90th $12–$1260%50%90th$12$2.0$10.0$50.0$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 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $239.88 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $15.14 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $125.89 / $125.89