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
HC (SUP SHELL Q4113) GRAFTJACKET XPRESS, INJECTABLE, 1 CC
Low
$285
Average
$3.8k
Median
$2.6k
High
$11.2k
Each hospital's average Phcs rate, under the methodology and billing class chosen below.
64 hospitals; the 90th percentile is 9.0× 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.
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78 hospital rates
iThe hospitals that file a Phcs rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 2 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 3 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 4 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 5 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 6 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 7 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 8 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 9 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 10 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 12 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 13 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 14 | BETHESDA HOSPITAL BOYNTON BEACH, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 15 | DOCTORS HOSPITAL CORAL GABLES, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 16 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 17 | FISHERMENS HEALTH, INC MARATHON, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 18 | HOMESTEAD HOSPITAL Homestead, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 19 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 20 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 21 | MARINERS HOSPITAL TAVERNIER, FL percent of total billed charges · bothfrom % of charges | 1 | $11.2k | $11.2k | — | — | — | $11.2k – $11.2k |
| 22 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 23 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 24 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 25 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $285 | $285 | — | — | — | $285 – $285 |
← Payers reporting HCPCS Q4113 · Snapshot 20261112T181611Z-3fa9fb76