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 Q4205) MEMBRANE GRAFT OR WRAP SQ CM
Low
$1
Average
$277
Median
$177
High
$2.4k
Each hospital's average Kaiser rate, under the methodology and billing class chosen below.
71 hospitals; the 90th percentile is 185.1× 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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74 hospital rates
iThe hospitals that file a Kaiser 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 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 3 | $255 | $235 | $84 | 36% | — | $135 – $325 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $191 | $191 | $23 | 12% | — | $168 – $214 |
| 3 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 7 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 11 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 2 | $160 | $160 | — | — | — | $160 – $160 |
| 12 | COMMONSPIRIT KANSAS, INC. Dodge City, KS fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 13 | COMMONSPIRIT KANSAS, INC. Garden City, KS fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 14 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 3 | $1.4k | $1.3k | $537 | 41% | — | $472 – $2.9k |
| 15 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 3 | $1.4k | $1.3k | $537 | 41% | — | $472 – $2.9k |
| 16 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · case rate · outpatient | 1 | $160 | $160 | — | — | — | $160 – $160 |
| 17 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 18 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · outpatient | 2 | $488 | $488 | — | — | — | $488 – $488 |
| 19 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $589 | $589 | — | — | — | $589 – $589 |
| 20 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $7 | $7 | $0 | 3% | — | $6 – $7 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 25 | Kadlec Regional Medical Center Kennewick, WA fee schedule · outpatient | 2 | $264 | $264 | $125 | 47% | — | $139 – $390 |
← Payers reporting HCPCS Q4205 · Snapshot 20261112T181611Z-3fa9fb76