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Oasis Ultra Tri-Layer Wound Matrix

New Mexico 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 New Mexico, 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 $53.70 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 6 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 $3.16
FacilityA hospital or hospital-owned outpatient department$53.70$15.14 to $87.10

How much rates vary

Facilitymedian $54 · 10th to 90th $3 to $209Professionalmedian $3 · 10th to 90th $3 to $126
$10.0$100.0$1.0K$10.0K$100.0Kfacility $54professional $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
$3.16
BCBS
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$57.54
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$10.47
Typical High
$60.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$7.24
Typical High
$204.17
Providence
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where New Mexico 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.

New Mexico $2.51 · 35th 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.