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New Jersey rates for HCPCS Q4103

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

Facilitymedian $1,995 · 10th–90th $13–$20,4170%5%10th90th$1,995Professionalmedian $12 · 10th–90th $12–$1260%50%90th$12$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $19.05 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $165.96
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $8,709.64 / $23,988.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $18.20 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $13.49 / $125.89