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 DRT OMNIGF 1SQCM
Low
$73
Average
$2.0k
Median
$350
High
$20.6k
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. 18 hospitals; the 90th percentile is 37.2× 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 | — | — | — | $135 – $1.4k |
| 2 | Hca Healthone Northeast Er THORNTON, CO | $350 | $350 | — | — | — | $135 – $1.4k |
| 3 | Natchez Hospital Company LLC Natchez, MS | $118 | $118 | — | — | — | $109 – $272 |
| 4 | Porter Hospital LLC Valparaiso, IN | $132 | $132 | — | — | — | $117 – $537 |
| 5 | Northwest Sahurita Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $252 |
| 6 | Northwest Sahurita Hospital LLC Sahuarita, AZ | $132 | $132 | $1 | 1% | — | $131 – $252 |
| 7 | Oro Valley Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $305 |
| 8 | Northwest Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $305 |
| 9 | Bullhead City Hospital Corporation City, AZ | $356 | $356 | — | — | — | $140 – $363 |
| 10 | Manatee Memorial Hospital Bradenton, FL | $673 | $602 | $88 | 15% | — | $474 – $673 |
Ask Claude or any MCP client for HCPCS Q4105 pricing at a specific hospital — see how to connect.