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West Virginia rates for HCPCS Q4103

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

Facilitymedian $78 · 10th–90th $12–$850%50%10th90th$78Professionalmedian $12 · 10th–90th $12–$780%50%90th$12$20.0$50.0$100.0$200.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $14.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $125.89 / $125.89