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Oasis Burn Matrix

Virginia 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?

$12.59

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $12.59 for this service. The price depends on where it is billed: about $12.59 from a physician practice, and about $151 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.59$12.02 to $126
FacilityA hospital or hospital-owned outpatient department$151$13.49 to $240

How much rates vary

Facilitymedian $151 · 10th to 90th $13 to $316Professionalmedian $13 · 10th to 90th $12 to $126
$10$20$50$100$200facility $151professional $13

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
$13.18
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$13.18
Typical High
$13.18
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.59
CareFirst
Setting
Professional
Modifier
None
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$223.87
Typical High
$331.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$14.45
Median
$138.04
Typical High
$194.98
Medcost
Setting
Professional
Modifier
None
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
Medcost
Setting
Facility
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$19.95
Medcost
Setting
Professional
Modifier
None
Typical Low
$4.37
Median
$14.13
Typical High
$109.65
Sentara
Setting
Facility
Modifier
None
Typical Low
$12.02
Median
$13.49
Typical High
$14.13
Sentara
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$14.13
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$128.82

Where Virginia 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.

Virginia· 51st of 51

$12.59

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.