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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 October 2026.

How much does Oasis Burn Matrix cost?

$126

Typical negotiated rate. In North Dakota, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $12.59 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$141$12.88 to $263
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 $141 · 10th to 90th $13 to $295
$20$50$100$200facility $13professional $141

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$12.88
BCBS North Dakota
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$269.15
Typical High
$323.59
BCBS North Dakota
Setting
Professional
Modifier
22 · Increased work
Typical Low
$269.15
Median
$323.59
Typical High
$389.05
Cigna
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$22.91
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$15.85
Typical High
$16.22
Medica
Setting
Facility
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$20.89
Medica
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.59
Typical High
$13.80
United
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$125.89
Typical High
$141.25

Where North Dakota 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.

North Dakota· 11th of 51

$126

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.