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 Q4117) HYALOMATRIX
Low
$13
Average
$865
Median
$222
High
$2.8k
Each hospital's average Oscar rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 17.3× 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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58 hospital rates
iThe hospitals that file a Oscar 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 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $237 | $237 | — | — | — | $237 – $237 |
| 2 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 3 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $667 | $667 | — | — | — | $667 – $667 |
| 4 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $667 | $667 | — | — | — | $667 – $667 |
| 5 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $667 | $667 | — | — | — | $667 – $667 |
| 6 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 7 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 8 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 9 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 10 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 11 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 12 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 13 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 14 | Ingalls Memorial Hospital Harvey, IL fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 15 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 16 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $10 | $13 | $5 | 38% | — | $9 – $20 |
| 17 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $26 | $33 | $13 | 38% | — | $22 – $50 |
| 18 | Montefiore Medical Center Bronx, NY fee schedule · outpatient | 1 | $155 | $155 | — | — | — | $155 – $155 |
| 19 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · inpatientfrom % of charges | 1 | $466 | $466 | $413 | 89% | — | $53 – $879 |
| 20 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 1 | $388 | $388 | $344 | 89% | — | $45 – $732 |
| 21 | OHI West, Inc. Pinellas Park, FL fee schedule · outpatient | 1 | $270 | $270 | — | — | — | $270 – $270 |
| 22 | Overlook Medical Center Summit, NJ percent of total billed charges · bothfrom % of charges | 1 | $2.3k | $2.8k | $2.5k | 91% | — | $252 – $6.2k |
| 23 | SSM Health Care of Oklahoma, Inc Midwest City, OK fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 24 | SSM Health Care of Oklahoma, Inc Oklahoma City, OK fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 25 | Sarasota Memorial Hospital Sarasota, FL fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
← Payers reporting HCPCS Q4117 · Snapshot 20261111T120946Z-9134e7f7