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
OASIS BURN 3X3.5 150X-195
Phoenix, AZ
See all hospitals reporting HCPCS Q4103 →Price type
Dignity Health’s median price of $14 is 78% below the median hospital's median price ($65), higher than 19% 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: 7 payers, 16 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 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 2 | Cigna commercial|localplus surefit fee schedule · outpatient | $13 | $13 | $3 | 25% | — | $10 – $17 |
| 3 | Cigna commercial|exchange fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 4 | Cigna commercial|all other plans fee schedule · outpatient | $16 | $16 | $6 | 37% | — | $10 – $22 |
| 5 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $31 | $31 | $21 | 68% | — | $10 – $53 |
| 6 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $31 | $31 | $21 | 68% | — | $10 – $53 |
| 7 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $40 | $40 | $30 | 75% | — | $10 – $70 |
| 8 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $57 | $57 | $47 | 82% | — | $10 – $104 |
| 9 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $67 | $67 | $65 | 97% | — | $2 – $133 |
| 10 | Aetna commercial|all plans fee schedule · outpatient | $138 | $138 | $134 | 97% | — | $4 – $273 |
| 11 | Optum commercial|optumhealth fee schedule · outpatient | $167 | $167 | $162 | 97% | — | $5 – $329 |
| 12 | Cigna commercial|lifesource fee schedule · outpatient | $195 | $195 | $189 | 97% | — | $6 – $384 |
| 13 | First Health commercial|all plans fee schedule · inpatient | $248 | $248 | $241 | 97% | — | $7 – $489 |
| 14 | First Health commercial|all plans fee schedule · outpatient | $248 | $248 | $241 | 97% | — | $7 – $489 |
| 15 | MultiPlan commercial|all plans fee schedule · inpatient | $280 | $280 | $272 | 97% | — | $8 – $552 |
| 16 | MultiPlan commercial|all plans fee schedule · outpatient | $280 | $280 | $272 | 97% | — | $8 – $552 |
Last updated: Feb 28, 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.