Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
DRSG OASIS BURN WOUND MATRIX 3X3.5CM 10.5SQCM-Q4103-COST PER SQ CM
Elkader, IA
See all hospitals reporting HCPCS Q4103 →Price type
Central Community Hospital’s median price of $178 is 174% above the median hospital's median price ($65), higher than 89% of the 1,183 hospitals reporting HCPCS Q4103. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 11 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Wellmark wellmark medicare advantage facility · percent of total billed charges · bothfrom % of charges | $124 | $124 | — | — | — | $124 – $124 |
| 2 | Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges | $125 | $125 | — | — | — | $125 – $125 |
| 3 | UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges | $133 | $133 | — | — | — | $133 – $133 |
| 4 | Molina molina medicaid facility · percent of total billed charges · bothfrom % of charges | $152 | $152 | — | — | — | $152 – $152 |
| 5 | Aetna aetna facility · percent of total billed charges · bothfrom % of charges | $178 | $178 | — | — | — | $178 – $178 |
| 6 | First Health aetna facility · percent of total billed charges · bothfrom % of charges | $178 | $178 | — | — | — | $178 – $178 |
| 7 | Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges | $178 | $178 | — | — | — | $178 – $178 |
| 8 | Ambetter ambetter marketplace facility · percent of total billed charges · bothfrom % of charges | $211 | $211 | — | — | — | $211 – $211 |
| 9 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $211 | $211 | — | — | — | $211 – $211 |
| 10 | Cigna midlands choice facility · percent of total billed charges · bothfrom % of charges | $236 | $236 | — | — | — | $236 – $236 |
| 11 | Medica midlands choice facility · percent of total billed charges · bothfrom % of charges | $236 | $236 | — | — | — | $236 – $236 |
Last updated: Mar 31, 2026
See Oasis wound matrix for burns pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.