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
$3
Average
$35
Median
$15
High
$200
Each hospital's average Superior Healthplan rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 12.8× 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.
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10 hospital rates
iThe hospitals that file a Superior Healthplan 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 Central Texas Killeen, TX fee schedule · outpatient | 1 | $200 | $200 | — | — | — | $200 – $200 |
| 2 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 5 | $7 | $8 | $2 | 30% | — | $5 – $12 |
| 3 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX percent of total billed charges · outpatientfrom % of charges | 5 | $3 | $3 | — | — | — | $3 – $3 |
| 4 | HCA HOUSTON HEALTHCARE KINGWOOD KINGWOOD, TX percent of total billed charges · outpatientfrom % of charges | 5 | $38 | $45 | $16 | 36% | — | $32 – $74 |
| 5 | HCA HOUSTON HEALTHCARE WEST STAFFORD, TX percent of total billed charges · outpatientfrom % of charges | 5 | $27 | $27 | — | — | — | $27 – $27 |
| 6 | HCA HOUSTON MAINLAND Texas City, TX percent of total billed charges · outpatientfrom % of charges | 5 | $1 | $5 | $5 | 110% | — | $1 – $13 |
| 7 | MEDICAL CITY DENTON Denton, TX percent of total billed charges · outpatientfrom % of charges | 5 | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Medical City Argyle Argyle, TX percent of total billed charges · outpatientfrom % of charges | 5 | $12 | $12 | — | — | — | $12 – $12 |
| 9 | ST DAVIDS REHAB Austin, TX percent of total billed charges · outpatientfrom % of charges | 7 | $16 | $19 | $14 | 75% | — | $6 – $53 |
| 10 | ST. DAVID'S MEDICAL CENTER Manor, TX percent of total billed charges · outpatientfrom % of charges | 7 | $16 | $19 | $14 | 75% | — | $6 – $53 |
← Payers reporting HCPCS Q4117 · Snapshot 20261111T120946Z-9134e7f7