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
BMWD 4X10IN 5965X-7755
Phoenix, AZ
See all hospitals reporting HCPCS Q4104 →Price type
Agh Laveen Llc’s median price of $149 is 10% above the median hospital's median price ($136), higher than 55% of the 1,714 hospitals reporting HCPCS Q4104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 2 | Cigna commercial|all other plans fee schedule · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 3 | Cigna commercial|ppo fee schedule · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 4 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $149 | $149 | — | — | — | $149 – $149 |
| 5 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $149 | $149 | — | — | — | $149 – $149 |
| 6 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 7 | MultiPlan commercial|all plans fee schedule · inpatient | $16.6k | $19.3k | $5.7k | 30% | — | $14.0k – $27.2k |
| 8 | MultiPlan commercial|all plans fee schedule · outpatient | $16.6k | $19.3k | $5.7k | 30% | — | $14.0k – $27.2k |
Last updated: Feb 28, 2026
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