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Oasis Ultra Tri-Layer Wound Matrix

New Jersey 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?

$2.57

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $2.57 for this service. The price depends on where it is billed: about $2.51 from a physician practice, and about $275 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 5 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 $9.12
FacilityA hospital or hospital-owned outpatient department$275$21.88 to $11,482

How much rates vary

Facilitymedian $275 · 10th to 90th $3 to $18,197Professionalmedian $3 · 10th to 90th $3 to $126
$10$100$1K$10Kfacility $275professional $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
$2.75
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.80
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$12.88
Typical High
$218.78
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$9,549.93
Typical High
$20,417.38
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$9.12
Typical High
$9.12
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$125.89
Typical High
$125.89

Where New Jersey 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.

New Jersey· 26th of 51

$2.57

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.