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 Q4180) REVITA, PER SQ CM
Low
$16
Average
$403
Median
$202
High
$1.9k
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
94 hospitals; the 90th percentile is 20.4× 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.
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105 hospital rates
iThe hospitals that file a Caresource 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 · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $179 | $179 | $58 | 32% | — | $121 – $238 |
| 3 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 4 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 5 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 6 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 2 | $0 | $16 | $23 | 141% | — | $0 – $49 |
| 7 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 2 | $25 | $25 | $25 | 100% | — | $0 – $49 |
| 8 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 2 | $25 | $25 | $25 | 100% | — | $0 – $49 |
| 9 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 2 | $25 | $25 | $25 | 100% | — | $0 – $49 |
| 10 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 11 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $25 | $25 | $25 | 100% | — | $0 – $49 |
| 12 | FAIRVIEW PARK HOSPITAL DUBLIN, GA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 13 | Fort Hamilton Hospital Hamilton, OH fee schedule · outpatient | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 14 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 15 | Greene Memorial Hospital Inc Xenia, OH fee schedule · outpatient | 1 | $188 | $188 | — | — | — | $188 – $188 |
| 16 | Greenfield Area Medical Center Greenfield, OH facility · case rate · outpatient | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 17 | HCA FLORIDA BAYONET POINT HOSPITAL HUDSON, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 18 | HCA FLORIDA BLAKE HOSPITAL PALMETTO, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 19 | HCA FLORIDA BRANDON HOSPITAL TEMPLE TERRACE, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 20 | HCA FLORIDA CITRUS HOSPITAL Inverness, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 21 | HCA FLORIDA ENGLEWOOD HOSPITAL VENICE, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 22 | HCA FLORIDA FAWCETT HOSPITAL CAPE CORAL, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | HCA FLORIDA LARGO HOSPITAL CLEARWATER, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 24 | HCA FLORIDA LARGO WEST HOSPITAL LARGO, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 25 | HCA FLORIDA LEHIGH HOSPITAL LEHIGH ACRES, FL fee schedule · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
← Payers reporting HCPCS Q4180 · Snapshot 20261112T181611Z-3fa9fb76