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
dextranomer-sodium hyaluronate 50 mg-15 mg Gel
Conway, SC
See all hospitals reporting HCPCS L8604 →Price type
Conway Hospital, Inc.’s median price of $3.3k is 9% below the median hospital's median price ($3.6k), higher than 45% of the 526 hospitals reporting HCPCS L8604. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna commercial professional · fee schedule · outpatient | $109 | $109 | — | — | — | $109 – $109 |
| 2 | Blue Cross Blue Shield narrow network facility · percent of total billed charges · inpatientfrom % of charges | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 3 | Blue Cross Blue Shield exchange facility · percent of total billed charges · inpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 4 | Blue Cross Blue Shield state health plan facility · percent of total billed charges · inpatientfrom % of charges | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 5 | Medcost commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 6 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $7.6k | $7.6k | — | — | — | $7.6k – $7.6k |
| 7 | Blue Cross Blue Shield ppo facility · percent of total billed charges · inpatientfrom % of charges | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 8 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
Last updated: May 20, 2026
See Prefilled Deflux injectable gel syringe, 1 mL pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.