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Oasis Ultra Tri-Layer Wound Matrix

Nevada 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 October 2026.

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

$12.88

Typical negotiated rate. In Nevada, October 2026.

Insurers have agreed to pay about $12.88 for this service. The price depends on where it is billed: about $12.88 from a physician practice, and about $141 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.88$2.51 to $126
FacilityA hospital or hospital-owned outpatient department$141$126 to $191

How much rates vary

Facilitymedian $141 · 10th to 90th $120 to $288Professionalmedian $13 · 10th to 90th $3 to $126
$10$100$1Kfacility $141professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2.51
Median
$2.51
Typical High
$2.69
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$2.51
Typical High
$2.69
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.26
Median
$1.26
Typical High
$1.35
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.50
Median
$0.50
Typical High
$0.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.37
Median
$0.37
Typical High
$0.41
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.25
Median
$0.25
Typical High
$0.27
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$151.36
Typical High
$288.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Hometown Health
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$147.91
Select Health
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$4,265.80
Select Health
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$131.83
Typical High
$154.88
United
Setting
Professional
Modifier
None
Typical Low
$14.45
Median
$125.89
Typical High
$128.82

Where Nevada sits

The same service costs 50.1 times more in Massachusetts than in Indiana. 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.

Nevada· 32nd of 51

$12.88

MA $126IN $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.