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
INTEGRA MESHED MATRIX 20X25= 500 SQ CM
Clovis, CA
See all hospitals reporting HCPCS Q4105 →Price type
Clovis Community Medical Center’s median price of $160 is 27% above the median hospital's median price ($127), higher than 71% of the 1,338 hospitals reporting HCPCS Q4105. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 28 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 medi-cal facility · fee schedule · inpatient | $12 | $12 | — | — | — | $12 – $12 |
| 2 | Molina managed medi-cal facility · fee schedule · inpatient | $12 | $12 | — | — | — | $12 – $12 |
| 3 | Blue Cross Blue Shield epn facility · fee schedule · inpatient | $24 | $24 | — | — | — | $24 – $24 |
| 4 | Aetna medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 5 | Aetna medicare hmo for chp facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 6 | Aetna ppo facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 7 | Blue Cross Blue Shield medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 8 | Cigna access (pffs) facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 9 | Cigna healthspring facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 10 | Humana medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 11 | Kaiser commercial facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 12 | Kaiser senior advantage medicare facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 13 | WellCare medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 14 | UnitedHealthcare medicare advantage facility · case rate · inpatient | $162 | $162 | — | — | — | $162 – $162 |
| 15 | Aetna hmoposppo facility · fee schedule · inpatient | $170 | $165 | $78 | 48% | — | $64 – $256 |
| 16 | Aetna qualified health plan facility · fee schedule · inpatient | $172 | $167 | $80 | 48% | — | $65 – $259 |
| 17 | Aetna medicare hmo for non-chp facility · case rate · inpatient | $168 | $168 | — | — | — | $168 – $168 |
| 18 | UnitedHealthcare hmo facility · fee schedule · inpatient | $195 | $189 | $90 | 48% | — | $73 – $294 |
| 19 | UnitedHealthcare ppo facility · fee schedule · inpatient | $195 | $189 | $90 | 48% | — | $73 – $294 |
| 20 | Cigna hmo facility · fee schedule · inpatient | $206 | $200 | $95 | 48% | — | $77 – $311 |
| 21 | Cigna ppo facility · fee schedule · inpatient | $206 | $200 | $95 | 48% | — | $77 – $311 |
| 22 | Blue Cross Blue Shield hmopos facility · fee schedule · inpatient | $207 | $201 | $96 | 48% | — | $78 – $312 |
| 23 | Blue Cross Blue Shield epoppo facility · fee schedule · inpatient | $211 | $205 | $98 | 48% | — | $79 – $319 |
| 24 | Blue Cross Blue Shield hmoppo facility · fee schedule · inpatient | $232 | $225 | $107 | 48% | — | $87 – $350 |
| 25 | Blue Cross Blue Shield exchange hmo facility · fee schedule · inpatient | $236 | $229 | $109 | 48% | — | $89 – $356 |
Last updated: Sep 11, 2026
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