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Oasis Burn Matrix

Michigan 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?

$14.45

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $14.45 for this service. The price depends on where it is billed: about $14.45 from a physician practice, and about $33.88 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$14.45$12.88 to $120
FacilityA hospital or hospital-owned outpatient department$33.88$16.60 to $135

How much rates vary

Facilitymedian $34 · 10th to 90th $13 to $135Professionalmedian $14 · 10th to 90th $13 to $126
$20$50$100facility $34professional $14

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
$12.88
Median
$12.88
Typical High
$12.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$36.31
Typical High
$134.90
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.88
Typical High
$16.60
Priority Health
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Michigan 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.

Michigan· 35th of 51

$14.45

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.