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Oasis Burn Matrix

Minnesota rates for HCPCS Q4103

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

Rates data updated July 2026.

How much does Oasis Burn Matrix cost?

$102

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $31.62 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$102$12.59 to $126
FacilityA hospital or hospital-owned outpatient department$31.62$15.14 to $40.74

How much rates vary

Facilitymedian $32 · 10th to 90th $13 to $257Professionalmedian $102 · 10th to 90th $11 to $126
$5$10$20$50$100$200facility $32professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$13.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$18.62
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$107.15
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$33.88
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$15.14
Typical High
$16.22
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$33.11
Typical High
$47.86
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$17.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$26.92
Medica
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$16.98
United
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$125.89
Typical High
$239.88

Where Minnesota sits

The same service costs 8.1 times more in Minnesota than in Alabama. 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.

Minnesota· 1st of 51

$102

MN $102AL $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.