go back

Oasis Burn Matrix

New Mexico 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 $30 · 10th–90th $9$2090%10%20%10th90th$30Professionalmedian $13 · 10th–90th $13$1260%50%90th$13$2.0$20.0$200.0$2.0K$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
$15.85
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$31.62
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$17.38
Typical High
$60.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$6.03
Median
$13.80
Typical High
$177.83
Providence
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89