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
Restorigin 1 sq cm
Boulder, CO
See all hospitals reporting HCPCS Q4191 →Price type
Boulder Community Health’s median price of $214 is 42% below the median hospital's median price ($369), higher than 41% of the 917 hospitals reporting HCPCS Q4191. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 23 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 | Cigna commercial professional · fee schedule · both | $127 | $127 | — | — | — | $127 – $127 |
| 2 | UnitedHealthcare medicare advantage professional · fee schedule · both | $130 | $130 | $3 | 2% | — | $127 – $133 |
| 3 | Aetna medicare advantage facility · case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 4 | Anthem medicare advantage facility · case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 5 | Humana medicare advantage facility · case rate · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 6 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 7 | Anthem medicare advantage professional · fee schedule · both | $135 | $135 | — | — | — | $135 – $135 |
| 8 | Devoted medicare advantage professional · fee schedule · both | $135 | $135 | — | — | — | $135 – $135 |
| 9 | Humana medicare advantage professional · fee schedule · both | $135 | $135 | — | — | — | $135 – $135 |
| 10 | Kaiser medicare advantage facility · case rate · outpatient | $136 | $136 | $1 | 0% | — | $135 – $137 |
| 11 | Devoted medicare advantage facility · case rate · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 12 | Kaiser medicare advantage professional · fee schedule · both | $168 | $168 | — | — | — | $168 – $168 |
| 13 | Kaiser commercial professional · fee schedule · both | $214 | $214 | — | — | — | $214 – $214 |
| 14 | Kaiser commercial facility · case rate · outpatient | $290 | $290 | $35 | 12% | — | $255 – $325 |
| 15 | Kaiser managed care facility · case rate · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 16 | Anthem commercial professional · fee schedule · both | $412 | $412 | — | — | — | $412 – $412 |
| 17 | Anthem managed care professional · fee schedule · both | $412 | $412 | — | — | — | $412 – $412 |
| 18 | Anthem commercial facility · fee schedule · outpatient | $330 | $490 | $341 | 70% | — | $261 – $1.2k |
| 19 | Anthem managed care facility · fee schedule · outpatient | $529 | $529 | — | — | — | $529 – $529 |
| 20 | UnitedHealthcare commercial professional · fee schedule · both | $730 | $730 | — | — | — | $730 – $730 |
| 21 | Aetna medicare advantage professional · fee schedule · both | $774 | $774 | — | — | — | $774 – $774 |
| 22 | Cigna commercial facility · fee schedule · outpatient | $940 | $940 | — | — | — | $940 – $940 |
| 23 | Aetna commercial professional · fee schedule · both | $1.1k | $1.1k | $341 | 31% | — | $774 – $1.5k |
Last updated: Sep 16, 2026
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