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Oasis Burn Matrix

New York 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 New York, 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 $14.45 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 9 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 $126
FacilityA hospital or hospital-owned outpatient department$14.45$14.45 to $178

How much rates vary

Facilitymedian $14 · 10th to 90th $14 to $302Professionalmedian $14 · 10th to 90th $13 to $135
$5$10$20$50$100$200$500facility $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
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$14.13
CDPHP
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Cigna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$186.21
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$138.04
Typical High
$338.84
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$151.36
Excellus BCBS
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$14.45
Typical High
$14.45
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.45
Typical High
$14.45
MVP Health Care
Setting
Facility
Modifier
None
Typical Low
$15.85
Median
$15.85
Typical High
$27.54
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$15.85
Typical High
$15.85
United
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$125.89
Typical High
$165.96
Univera
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$14.45
Typical High
$14.45
Univera
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.45
Typical High
$14.45

Where New York 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.

New York· 36th 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.