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
ALLOGRAFT CYMETRA 2MG/PER MG
Arlington, TX
See all hospitals reporting HCPCS Q4112 →Price type
AMH Cath Labs LLC’s median price of $390 is 60% below the median hospital's median price ($963), higher than 13% of the 785 hospitals reporting HCPCS Q4112. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $55 | $55 | — | — | — | $55 – $55 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $55 | $55 | — | — | — | $55 – $55 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $60 | $60 | — | — | — | $60 – $60 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $61 | $61 | — | — | — | $61 – $61 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $214 | $214 | — | — | — | $214 – $214 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $254 | $254 | — | — | — | $254 – $254 |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $285 | $285 | — | — | — | $285 – $285 |
| 9 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $320 | $320 | — | — | — | $320 – $320 |
| 10 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $339 | $339 | — | — | — | $339 – $339 |
| 11 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $339 | $339 | — | — | — | $339 – $339 |
| 12 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $342 | $342 | — | — | — | $342 – $342 |
| 13 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $430 | $430 | — | — | — | $430 – $430 |
| 14 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $432 | $432 | — | — | — | $432 – $432 |
| 15 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $434 | $434 | — | — | — | $434 – $434 |
| 16 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $434 | $434 | — | — | — | $434 – $434 |
| 17 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $461 | $461 | — | — | — | $461 – $461 |
| 18 | Blue Cross Blue Shield hmo fee schedule · outpatient | $464 | $464 | — | — | — | $464 – $464 |
| 19 | Blue Cross Blue Shield exchange fee schedule · outpatient | $475 | $475 | — | — | — | $475 – $475 |
| 20 | Blue Cross Blue Shield ppo fee schedule · outpatient | $515 | $515 | — | — | — | $515 – $515 |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $539 | $539 | — | — | — | $539 – $539 |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $539 | $539 | — | — | — | $539 – $539 |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $583 | $583 | — | — | — | $583 – $583 |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $583 | $583 | — | — | — | $583 – $583 |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
Last updated: Apr 21, 2026
See Cymetra allograft kit, 2 cc (not in use) pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.