Oasis ultra tri-layer wound matrix, per square centimeter at Medical City Plano

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

OASIS TRI-LAYER 1SQCM

Plano, TX

See all hospitals reporting HCPCS Q4124 →

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Pricing by billing methodology

Price type

How this price compares nationally

Medical City Plano’s median price of $101 is 6% below the median hospital's median price ($108), higher than 49% of the 1,428 hospitals reporting HCPCS Q4124. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4124 at Medical City Plano

Negotiated rates from the hospital’s own file: 7 payers, 36 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	Humana tricare fee schedule · outpatient	$9	$9	—	—	—	$9 – $9
2	Cigna localplus fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
3	Cigna newbusiness fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
4	Cigna hmo fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
5	Cigna networkbenefit fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
6	Cigna openaccessplus fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
7	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$19	$19	$4	23%	—	$15 – $24
8	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$19	$19	$4	23%	—	$15 – $24
9	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$19	$19	$4	23%	—	$15 – $24
10	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$19	$19	$4	23%	—	$15 – $24
11	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$19	$19	$4	23%	—	$15 – $24
12	Cigna allother fee schedule · outpatient	$21	$21	—	—	—	$21 – $21
13	Cigna ifp percent of total billed charges · outpatientfrom % of charges	$37	$37	$9	23%	—	$28 – $45
14	Cigna qhp percent of total billed charges · outpatientfrom % of charges	$38	$38	$9	23%	—	$29 – $47
15	Aetna qhphix percent of total billed charges · outpatientfrom % of charges	$44	$44	$10	23%	—	$34 – $55
16	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$47	$47	$11	23%	—	$36 – $58
17	Aetna newbusiness percent of total billed charges · outpatientfrom % of charges	$65	$65	$15	23%	—	$50 – $80
18	Blue Cross Blue Shield blueadvantagehmo percent of total billed charges · outpatientfrom % of charges	$67	$67	$16	23%	—	$52 – $83
19	Blue Cross Blue Shield mybluehealth percent of total billed charges · outpatientfrom % of charges	$67	$67	$16	23%	—	$52 – $83
20	Aetna comm percent of total billed charges · outpatientfrom % of charges	$70	$70	$16	23%	—	$54 – $86
21	Aetna meritain percent of total billed charges · outpatientfrom % of charges	$70	$70	$16	23%	—	$54 – $86
22	Blue Cross Blue Shield bluepremier percent of total billed charges · outpatientfrom % of charges	$80	$80	$19	23%	—	$61 – $98
23	Aetna oon percent of total billed charges · outpatientfrom % of charges	$82	$82	$19	23%	—	$63 – $101
24	Blue Cross Blue Shield blueessentials percent of total billed charges · outpatientfrom % of charges	$87	$87	$20	23%	—	$67 – $107
25	Blue Cross Blue Shield blueessentialsaccess percent of total billed charges · outpatientfrom % of charges	$87	$87	$20	23%	—	$67 – $107

Page 1 of 2 · 36 rates

Last updated: Mar 1, 2026

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