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Oasis Ultra Tri-Layer Wound Matrix

Florida rates for HCPCS Q4124

OASIS ultra tri-layer wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Oasis Ultra Tri-Layer Wound Matrix cost?

$2.51

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $2.51 for this service. The price depends on where it is billed: about $2.51 from a physician practice, and about $126 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.51$2.51 to $3.47
FacilityA hospital or hospital-owned outpatient department$126$2.51 to $70,795

How much rates vary

Facilitymedian $126 · 10th to 90th $3 to $154,882Professionalmedian $3 · 10th to 90th $3 to $126
$10$100$1K$10K$100Kfacility $126professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.95
AvMed
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$107.15
Typical High
$125.89
AvMed
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$97.72
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$102,329.30
Typical High
$208,929.61
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$93.33
Typical High
$141.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$125.89
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$125.89
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$134.90
Typical High
$134.90

Where Florida sits

The same service costs 16.6 times more in Minnesota than in Illinois. 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.

Florida· 36th of 51

$2.51

MN $41.69IL $2.51

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.