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Oasis Burn Matrix

Oklahoma 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?

$126

Typical negotiated rate. In Oklahoma, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $13.49 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$12.59 to $126
FacilityA hospital or hospital-owned outpatient department$13.49$1.86 to $151

How much rates vary

Facilitymedian $13 · 10th to 90th $2 to $191Professionalmedian $126 · 10th to 90th $12 to $6,166
$10$100$1Kfacility $13professional $126

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
$13.49
Median
$13.49
Typical High
$13.49
Aetna
Setting
Professional
Modifier
None
Typical Low
$13.49
Median
$13.49
Typical High
$13.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$169.82
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
None
Typical Low
$1.86
Median
$1.86
Typical High
$18.20
Medica
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$6,165.95
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Oklahoma 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.

Oklahoma· 17th of 51

$126

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.