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North Dakota rates for HCPCS Q4103

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

Facilitymedian $12 · 10th–90th $12–$210%50%90th$12Professionalmedian $12 · 10th–90th $11–$160%50%10th90th$12$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $16.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $11.22 / $14.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $22.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $14.45 / $22.39
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $13.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $125.89 / $239.88