HCPCS Q4289
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
Revoshield+ amnio, per sq cm
Low
$8
Average
$882
Median
$715
High
$3.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
43 payers; the 90th percentile is 15.3× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +5 other terms | 421 | $299 | $1.3k | $1.8k | 136% | — | $48 – $10.0k |
| 2 | Cigna fee schedule · outpatient · +5 other terms | 241 | $2.2k | $3.4k | $3.4k | 99% | — | $119 – $12.6k |
| 3 | Aetna fee schedule · outpatient · +4 other terms | 213 | $145 | $869 | $2.2k | 253% | — | $69 – $22.2k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 180 | $126 | $501 | $1.2k | 231% | — | $1 – $7.3k |
| 5 | Humana fee schedule · outpatient · +4 other terms | 172 | $170 | $727 | $703 | 97% | — | $48 – $1.7k |
| 6 | Molina fee schedule · outpatient · +3 other terms | 79 | $201 | $884 | $1.6k | 178% | — | $51 – $4.5k |
| 7 | Caresource fee schedule · outpatient · +2 other terms | 60 | $1.6k | $932 | $1.1k | 121% | — | $48 – $3.2k |
| 8 | Anthem facility · fee schedule · outpatient · +4 other terms | 53 | $177 | $1.0k | $1.3k | 132% | — | $48 – $5.5k |
| 9 | WellCare fee schedule · outpatient · +3 other terms | 48 | $138 | $244 | $377 | 154% | — | $119 – $1.6k |
| 10 | Kaiser fee schedule · outpatient · +3 other terms | 41 | $207 | $365 | $491 | 135% | — | $125 – $3.9k |
← Hospitals reporting HCPCS Q4289 · Snapshot 20261113T090226Z-3ce6c0b8