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Oasis Burn Matrix

Massachusetts 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 Massachusetts, 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 $135 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$12.59 to $155
FacilityA hospital or hospital-owned outpatient department$135$25.12 to $204

How much rates vary

Facilitymedian $135 · 10th to 90th $14 to $234Professionalmedian $126 · 10th to 90th $13 to $275
$20$100$500$2Kfacility $135professional $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
Facility
Modifier
None
Typical Low
$11.22
Median
$11.22
Typical High
$12.59
Aetna
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$12.59
Typical High
$12.59
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$39.81
Median
$125.89
Typical High
$204.17
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$125.89
Typical High
$6,165.95
BCBS
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$16.22
Typical High
$29.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$229.09
Typical High
$389.05
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$181.97
Typical High
$363.08
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$199.53
Typical High
$234.42
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$125.89
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$39.81
Median
$125.89
Typical High
$204.17
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$125.89
Typical High
$6,165.95
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
Well Sense
Setting
Facility
Modifier
None
Typical Low
$12.88
Median
$17.78
Typical High
$26.30
Well Sense
Setting
Professional
Modifier
None
Typical Low
$4.57
Median
$4.57
Typical High
$5.50

Where Massachusetts sits

The same service costs 10.0 times more in Illinois than in Pennsylvania. 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.

Massachusetts· 7th of 51

$126

IL $126PA $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.