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
INTEGRA BMWD 1SQCM
Low
$14
Average
$1.2k
Median
$356
High
$19.6k
Filter by billing methodology
Reflects a negotiated per diem rate paid per day of care.
Showing only prices reported under the per diem methodology. Choose another in the filter above to change the chart. 57 hospitals; the 90th percentile is 28.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Hca Healthone Mountain Ridge Thornton, CO | $350 | $350 | — | — | — | $72 – $1.2k |
| 2 | Hca Healthone Northeast Er THORNTON, CO | $350 | $350 | — | — | — | $72 – $1.2k |
| 3 | IOM Health System LP Fort Wayne, IN | $132 | $132 | — | — | — | $117 – $541 |
| 4 | Bluffton Health System LLC Bluffton, IN | $132 | $132 | — | — | — | $117 – $541 |
| 5 | Dukes Health System LLC Peru, IN | $14 | $14 | — | — | — | $13 – $118 |
| 6 | Warsaw Health System LLC Warsaw, IN | $141 | $141 | — | — | — | $125 – $541 |
| 7 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN | $197 | $197 | $66 | 33% | — | $117 – $541 |
| 8 | St. Joseph Health System, LLC Wayne, IN | $132 | $132 | — | — | — | $117 – $541 |
| 9 | Dupont Hospital LLC Wayne, IN | $165 | $165 | $33 | 20% | — | $117 – $541 |
| 10 | Porter Hospital LLC Valparaiso, IN | $132 | $132 | — | — | — | $117 – $537 |
Ask Claude or any MCP client for HCPCS Q4104 pricing at a specific hospital — see how to connect.