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Oasis Burn Matrix

New Jersey rates for HCPCS Q4103

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

Rates data updated July 2026.

Facilitymedian $269 · 10th–90th $13$18,1970%10%10th90th$269Professionalmedian $13 · 10th–90th $13$1260%50%90th$13$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
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
$13.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$19.05
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$162.18
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$8,709.64
Typical High
$20,417.38
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$83.18
Typical High
$125.89