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Oasis Burn Matrix

Nebraska 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?

$14.13

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $14.13 for this service. The price depends on where it is billed: about $14.13 from a physician practice, and about $13.80 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$14.13$12.59 to $120
FacilityA hospital or hospital-owned outpatient department$13.80$12.59 to $15.49

How much rates vary

Facilitymedian $14 · 10th to 90th $12 to $224Professionalmedian $14 · 10th to 90th $12 to $126
$10$50$200$1K$5Kfacility $14professional $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
$12.59
Median
$12.59
Typical High
$12.59
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$11.75
Median
$13.80
Typical High
$14.13
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$13.49
Median
$14.13
Typical High
$14.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$208.93
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.79
Typical High
$158.49
Medica
Setting
Facility
Modifier
None
Typical Low
$12.30
Median
$23.44
Typical High
$100.00
Medica
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$12.30
Typical High
$16.22
Midlands
Setting
Professional
Modifier
None
Typical Low
$14.45
Median
$14.79
Typical High
$316.23
Midlands
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$208.93
Typical High
$331.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$14.45
Median
$15.49
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Nebraska 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.

Nebraska· 39th of 51

$14.13

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.