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 Q4168) AMNIOBAND, 1 MG
Low
$10
Average
$684
Median
$35
High
$3.3k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
79 hospitals; the 90th percentile is 170.4× 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
91 hospital rates
iThe hospitals that file a Molina 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 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 3 | COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · inpatient | 1 | $2.0k | $2.0k | $1.1k | 58% | — | $840 – $3.1k |
| 4 | COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · outpatient | 1 | $2.0k | $2.0k | $1.1k | 58% | — | $840 – $3.1k |
| 5 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 6 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 7 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 9 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 10 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 11 | City of Hope National Medical Center Duarte, CA percent of total billed charges · inpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 12 | City of Hope National Medical Center Duarte, CA percent of total billed charges · outpatientfrom % of charges | 2 | $1.4k | $1.4k | $181 | 13% | — | $1.2k – $1.6k |
| 13 | Columbus Regional Healthcare System, Inc Whiteville, NC case rate · inpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 14 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 15 | DIGNITY COMMUNITY CARE Glendale, CA fee schedule · inpatient | 1 | $2.0k | $2.0k | $1.1k | 58% | — | $840 – $3.1k |
| 16 | DIGNITY COMMUNITY CARE Glendale, CA fee schedule · outpatient | 1 | $2.0k | $2.0k | $1.1k | 58% | — | $840 – $3.1k |
| 17 | DIGNITY COMMUNITY CARE Sacramento, CA fee schedule · inpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 18 | DIGNITY COMMUNITY CARE Sacramento, CA fee schedule · outpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 19 | DIGNITY HEALTH Carmichael, CA fee schedule · inpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 20 | DIGNITY HEALTH Carmichael, CA fee schedule · outpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 21 | DIGNITY HEALTH Folsom, CA fee schedule · inpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 22 | DIGNITY HEALTH Folsom, CA fee schedule · outpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 23 | DIGNITY HEALTH Sacramento, CA fee schedule · inpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 24 | DIGNITY HEALTH Sacramento, CA fee schedule · outpatient | 1 | $2.8k | $2.8k | $721 | 26% | — | $2.1k – $3.5k |
| 25 | DIGNITY HEALTH San Bernardino, CA fee schedule · inpatient | 2 | $2.0k | $2.0k | $1.1k | 58% | — | $840 – $3.1k |
← Payers reporting HCPCS Q4168 · Snapshot 20261111T120946Z-9134e7f7