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Oasis Burn Matrix

North Dakota 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?

$12.59

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $12.59 for this service. The price depends on where it is billed: about $12.59 from a physician practice, and about $12.59 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 5 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$12.59$11.22 to $13.18
FacilityA hospital or hospital-owned outpatient department$12.59$12.59 to $12.59

How much rates vary

Facilitymedian $13 · 10th to 90th $12 to $21Professionalmedian $13 · 10th to 90th $11 to $16
$2$5$10$20$50$100facility $13professional $13

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
$23.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$11.48
Typical High
$14.45
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$22.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$15.85
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$14.45
Typical High
$22.39
Medica
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$13.80
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$125.89
Typical High
$239.88

Where North Dakota 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.

North Dakota· 27th of 51

$12.59

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.