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 Q4138) BIODFENCE DRYFLEX, 1CM
Low
$109
Average
$7.1k
Median
$11.9k
High
$14.5k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 66.5× 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.
Filter by billing methodology
Filter by billing class
38 hospital rates
iThe hospitals that file a First Health 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 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $706 | $706 | — | — | — | $706 – $706 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $706 | $706 | — | — | — | $706 – $706 |
| 3 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 4 | DIGNITY HEALTH Phoenix, AZ fee schedule · inpatient | 1 | $4.6k | $5.4k | $2.3k | 44% | — | $3.1k – $9.2k |
| 5 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 1 | $4.6k | $5.4k | $2.3k | 44% | — | $3.1k – $9.2k |
| 6 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 7 | Greenfield Area Medical Center Greenfield, OH facility · fee schedule · outpatient | 1 | $706 | $706 | — | — | — | $706 – $706 |
| 8 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 9 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 10 | Orlando Health Melbourne Hospital Melbourne, FL fee schedule · outpatient | 1 | $253 | $253 | — | — | — | $253 – $253 |
| 11 | Orlando Health Sebastian River Hospital Sebastian, FL fee schedule · outpatient | 1 | $253 | $253 | — | — | — | $253 – $253 |
| 12 | PIEDMONT MCDUFFIE HOSPITAL Thomson, GA percent of total billed charges · bothfrom % of charges | 1 | $14.5k | $14.5k | — | — | — | $14.5k – $14.5k |
| 13 | Piedmont Athens Regional Athens, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 14 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 15 | Piedmont Augusta Augusta, GA percent of total billed charges · bothfrom % of charges | 1 | $14.5k | $14.5k | — | — | — | $14.5k – $14.5k |
| 16 | Piedmont Cartersville Cartersville, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 17 | Piedmont Columbus Regional - Midtown Columbus, GA percent of total billed charges · bothfrom % of charges | 1 | $13.6k | $13.6k | — | — | — | $13.6k – $13.6k |
| 18 | Piedmont Columbus Regional - Northside Columbus, GA percent of total billed charges · bothfrom % of charges | 1 | $13.6k | $13.6k | — | — | — | $13.6k – $13.6k |
| 19 | Piedmont Eastside Snellville, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 20 | Piedmont Fayette Fayetteville, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 21 | Piedmont Henry Stockbridge, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 22 | Piedmont Macon Macon, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 23 | Piedmont Macon North Macon, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 24 | Piedmont Mountainside Jasper, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 25 | Piedmont Newnan Newnan, GA percent of total billed charges · bothfrom % of charges | 1 | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
← Payers reporting HCPCS Q4138 · Snapshot 20261112T124536Z-e251e855