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
OASIS WND 3X3.5CM 17X-23
Glendale, CA
See all hospitals reporting HCPCS Q4102 →Price type
Dignity Community Care’s median price of $109 is 125% above the median hospital's median price ($48), higher than 61% of the 1,631 hospitals reporting HCPCS Q4102. 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, 31 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 | Anthem medicaid|all plans fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 2 | Molina medicaid|all plans fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 3 | Kaiser medicaid|< 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 4 | Kaiser medicaid|> 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 5 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 6 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 7 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 8 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 9 | Anthem commercial|mcs fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 10 | Anthem commercial|non-mcs fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 11 | Molina medicaid|all plans fee schedule · inpatient | $152 | $196 | $159 | 81% | — | $26 – $496 |
| 12 | Anthem medicaid|all plans fee schedule · inpatient | $166 | $213 | $173 | 81% | — | $29 – $539 |
| 13 | Cigna commercial|all other plans fee schedule · inpatient | $199 | $256 | $207 | 81% | — | $35 – $647 |
| 14 | Cigna commercial|ppo fee schedule · inpatient | $199 | $256 | $207 | 81% | — | $35 – $647 |
| 15 | Kaiser commercial|all plans fee schedule · inpatient | $371 | $478 | $387 | 81% | — | $64 – $1.2k |
| 16 | Kaiser commercial|all plans fee schedule · outpatient | $371 | $478 | $387 | 81% | — | $64 – $1.2k |
| 17 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $398 | $512 | $414 | 81% | — | $69 – $1.3k |
| 18 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $398 | $512 | $414 | 81% | — | $69 – $1.3k |
| 19 | First Health commercial|all plans fee schedule · inpatient | $431 | $555 | $449 | 81% | — | $75 – $1.4k |
| 20 | First Health commercial|all plans fee schedule · outpatient | $431 | $555 | $449 | 81% | — | $75 – $1.4k |
| 21 | Cigna commercial|all other plans fee schedule · outpatient | $451 | $580 | $469 | 81% | — | $78 – $1.5k |
| 22 | Cigna commercial|ppo fee schedule · outpatient | $451 | $580 | $469 | 81% | — | $78 – $1.5k |
| 23 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $497 | $640 | $518 | 81% | — | $86 – $1.6k |
| 24 | MultiPlan commercial|all plans fee schedule · inpatient | $530 | $683 | $552 | 81% | — | $92 – $1.7k |
| 25 | MultiPlan commercial|all plans fee schedule · outpatient | $530 | $683 | $552 | 81% | — | $92 – $1.7k |
Last updated: Feb 28, 2026
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