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
TISSUE DERMAL MEMODERM (16SQ CM)4X4CM MESHED 19794
Low
$60
Average
$1.9k
Median
$2.2k
High
$7.0k
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 94 hospitals; the 90th percentile is 36.0× 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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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Methodist Hospitals of Dallas Southlake, TX | $134 | $180 | $64 | 36% | 28 | $37 – $338 |
| 2 | Methodist Hospitals of Dallas Coppell, TX | $134 | $180 | $64 | 36% | 28 | $37 – $338 |
| 3 | Wesley Health System LLC Hattiesburg, MS | $2.9k | $3.1k | $3.0k | 95% | — | $109 – $7.3k |
| 4 | Porter Hospital LLC Valparaiso, IN | $211 | $215 | $54 | 25% | — | $117 – $537 |
| 5 | Northwest Sahurita Hospital LLC Tucson, AZ | $91 | $95 | $51 | 54% | — | $18 – $252 |
| 6 | Victoria of Texas LP Victoria, TX | $125 | $111 | $76 | 69% | — | $16 – $275 |
| 7 | Victoria of Texas LP Victoria, TX | $125 | $111 | $76 | 69% | — | $16 – $275 |
| 8 | Northwest Sahurita Hospital LLC Sahuarita, AZ | $91 | $95 | $51 | 54% | — | $18 – $252 |
| 9 | Oro Valley Hospital LLC Tucson, AZ | $132 | $104 | $47 | 45% | — | $20 – $305 |
| 10 | Northwest Hospital LLC Tucson, AZ | $131 | $107 | $45 | 43% | — | $20 – $305 |
Ask Claude or any MCP client for HCPCS Q4126 pricing at a specific hospital — see how to connect.