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
CLARIX F 25MG 431X-561
Glendale, CA
See all hospitals reporting HCPCS Q4155 →Price type
Dignity Community Care’s median price of $1.9k is 3747% above the median hospital's median price ($50), higher than 92% of the 1,063 hospitals reporting HCPCS Q4155. 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, 27 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 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 2 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 3 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 4 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 5 | Molina medicaid|all plans fee schedule · inpatient | $1.3k | $1.3k | $440 | 35% | — | $645 – $1.8k |
| 6 | Molina medicaid|all plans fee schedule · outpatient | $1.3k | $1.3k | $440 | 35% | — | $645 – $1.8k |
| 7 | Anthem medicaid|all plans fee schedule · inpatient | $1.4k | $1.4k | $478 | 35% | — | $701 – $2.0k |
| 8 | Anthem medicaid|all plans fee schedule · outpatient | $1.4k | $1.4k | $478 | 35% | — | $701 – $2.0k |
| 9 | Cigna commercial|all other plans fee schedule · inpatient | $1.6k | $1.6k | $574 | 35% | — | $842 – $2.4k |
| 10 | Cigna commercial|ppo fee schedule · inpatient | $1.6k | $1.6k | $574 | 35% | — | $842 – $2.4k |
| 11 | Kaiser commercial|all plans fee schedule · inpatient | $3.1k | $3.0k | $1.1k | 35% | — | $1.6k – $4.5k |
| 12 | Kaiser commercial|all plans fee schedule · outpatient | $3.1k | $3.0k | $1.1k | 35% | — | $1.6k – $4.5k |
| 13 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $3.3k | $3.3k | $1.1k | 35% | — | $1.7k – $4.8k |
| 14 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $3.3k | $3.3k | $1.1k | 35% | — | $1.7k – $4.8k |
| 15 | First Health commercial|all plans fee schedule · inpatient | $3.5k | $3.5k | $1.2k | 35% | — | $1.8k – $5.2k |
| 16 | First Health commercial|all plans fee schedule · outpatient | $3.5k | $3.5k | $1.2k | 35% | — | $1.8k – $5.2k |
| 17 | Cigna commercial|all other plans fee schedule · outpatient | $3.7k | $3.7k | $1.3k | 35% | — | $1.9k – $5.5k |
| 18 | Cigna commercial|ppo fee schedule · outpatient | $3.7k | $3.7k | $1.3k | 35% | — | $1.9k – $5.5k |
| 19 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $4.1k | $4.1k | $1.4k | 35% | — | $2.1k – $6.0k |
| 20 | MultiPlan commercial|all plans fee schedule · inpatient | $4.4k | $4.3k | $1.5k | 35% | — | $2.2k – $6.4k |
| 21 | MultiPlan commercial|all plans fee schedule · outpatient | $4.4k | $4.3k | $1.5k | 35% | — | $2.2k – $6.4k |
| 22 | Blue Cross Blue Shield commercial|all other plans fee schedule · inpatient | $4.7k | $4.7k | $1.6k | 35% | — | $2.4k – $6.9k |
| 23 | Anthem commercial|mcs fee schedule · inpatient | $5.2k | $5.2k | $1.8k | 35% | — | $2.7k – $7.6k |
| 24 | Anthem commercial|non-mcs fee schedule · inpatient | $5.2k | $5.2k | $1.8k | 35% | — | $2.7k – $7.6k |
| 25 | Aetna commercial|all other plans fee schedule · inpatient | $5.4k | $5.4k | $1.9k | 35% | — | $2.8k – $7.9k |
Last updated: Feb 28, 2026
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