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
Membrane Pro3-C 18SqCM Thk Crd
Brookings, SD
See all hospitals reporting HCPCS Q4100 →Price type
Brookings Health System’s median price of $3.5k is 89% above the median hospital's median price ($1.8k), higher than 73% of the 968 hospitals reporting HCPCS Q4100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 7 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 commercial fee schedule · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 2 | Medica commercial percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.6k | $2.2k | 61% | — | $1.2k – $7.6k |
| 3 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $3.7k | $5.0k | $2.6k | 52% | — | $2.6k – $8.6k |
| 4 | Humana commercial percent of total billed charges · outpatientfrom % of charges | $4.0k | $5.4k | $2.8k | 52% | — | $2.8k – $9.3k |
| 5 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $4.4k | $5.8k | $3.0k | 52% | — | $3.0k – $10.0k |
| 6 | Medica medicare fee schedule · outpatient | $4.5k | $6.0k | $3.1k | 52% | — | $3.1k – $10.3k |
| 7 | Medicaid medicaid fee schedule · outpatient | $4.5k | $6.0k | $3.1k | 52% | — | $3.1k – $10.3k |
Last updated: May 18, 2026
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