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
DERMIS FLEXHD PLIABLE 9 X 15 CM 135 SQ CM
Clovis, CA
See all hospitals reporting HCPCS Q4128 →Price type
Clovis Community Medical Center’s median price of $160 is 21% above the median hospital's median price ($133), higher than 60% of the 1,531 hospitals reporting HCPCS Q4128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 26 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 | Aetna hmoposppo facility · fee schedule · inpatient | $58 | $59 | $16 | 28% | — | $18 – $82 |
| 2 | Aetna qualified health plan facility · fee schedule · inpatient | $59 | $59 | $16 | 28% | — | $18 – $83 |
| 3 | Cigna hmo facility · fee schedule · inpatient | $71 | $71 | $20 | 28% | — | $21 – $100 |
| 4 | Cigna ppo facility · fee schedule · inpatient | $71 | $71 | $20 | 28% | — | $21 – $100 |
| 5 | MultiPlan ppo facility · fee schedule · inpatient | $95 | $96 | $27 | 28% | — | $29 – $135 |
| 6 | Phcs commercial facility · fee schedule · inpatient | $95 | $96 | $27 | 28% | — | $29 – $135 |
| 7 | Aetna medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 8 | Aetna medicare hmo for chp facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 9 | Aetna ppo facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 10 | Blue Cross Blue Shield medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 11 | Cigna access (pffs) facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 12 | Cigna healthspring facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 13 | Humana medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 14 | Kaiser commercial facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 15 | Kaiser senior advantage medicare facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 16 | WellCare medicare advantage facility · case rate · inpatient | $160 | $160 | — | — | — | $160 – $160 |
| 17 | UnitedHealthcare medicare advantage facility · case rate · inpatient | $162 | $162 | — | — | — | $162 – $162 |
| 18 | Aetna medicare hmo for non-chp facility · case rate · inpatient | $168 | $168 | — | — | — | $168 – $168 |
| 19 | Blue Cross Blue Shield epn facility · fee schedule · inpatient | $63 | $330 | $1.3k | 388% | — | $17 – $6.3k |
| 20 | UnitedHealthcare hmo facility · fee schedule · inpatient | $74 | $391 | $1.5k | 388% | — | $20 – $7.5k |
| 21 | UnitedHealthcare ppo facility · fee schedule · inpatient | $74 | $391 | $1.5k | 388% | — | $20 – $7.5k |
| 22 | Blue Cross Blue Shield hmopos facility · fee schedule · inpatient | $79 | $416 | $1.6k | 388% | — | $22 – $8.0k |
| 23 | Blue Cross Blue Shield epoppo facility · fee schedule · inpatient | $81 | $424 | $1.6k | 388% | — | $22 – $8.2k |
| 24 | Blue Cross Blue Shield hmoppo facility · fee schedule · inpatient | $89 | $466 | $1.8k | 388% | — | $24 – $9.0k |
| 25 | Blue Cross Blue Shield exchange hmo facility · fee schedule · inpatient | $90 | $474 | $1.8k | 388% | — | $25 – $9.1k |
Last updated: Sep 11, 2026
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