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Oasis Ultra Tri-Layer Wound Matrix

Massachusetts 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 Massachusetts, 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 $17.38 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 8 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 $4.17
FacilityA hospital or hospital-owned outpatient department$17.38$14.13 to $135

How much rates vary

Facilitymedian $17 · 10th to 90th $8 to $234Professionalmedian $3 · 10th to 90th $3 to $126
$10.0$100.0$1.0K$10.0Kfacility $17professional $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
$8.13
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$7.24
Median
$125.89
Typical High
$707.95
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$125.89
Typical High
$223.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$28.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$181.97
Typical High
$1,995.26
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$181.97
Typical High
$275.42
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$4.57
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$7.24
Median
$125.89
Typical High
$707.95
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$125.89
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$10.23
Typical High
$125.89

Where Massachusetts sits

The same service costs 16.6 times more in Minnesota than in Illinois. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Massachusetts $2.51 · 34th of 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.