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
REVITA 2X3CM 730X-949
Los Angeles, CA
See all hospitals reporting HCPCS Q4180 →Price type
Dignity Community Care’s median price of $1.4k is 264% above the median hospital's median price ($391), higher than 85% of the 1,064 hospitals reporting HCPCS Q4180. 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, 29 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 | $208 | $208 | — | — | — | $208 – $208 |
| 2 | Molina medicaid|< 21 fee schedule · outpatient | $233 | $233 | — | — | — | $233 – $233 |
| 3 | Molina medicaid|> 21 fee schedule · outpatient | $233 | $233 | — | — | — | $233 – $233 |
| 4 | Kaiser medicaid|< 21 fee schedule · outpatient | $249 | $249 | — | — | — | $249 – $249 |
| 5 | Kaiser medicaid|> 21 fee schedule · outpatient | $249 | $249 | — | — | — | $249 – $249 |
| 6 | Anthem commercial|exchange fee schedule · outpatient | $651 | $651 | — | — | — | $651 – $651 |
| 7 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $831 | $831 | — | — | — | $831 – $831 |
| 8 | Anthem commercial|all other plans fee schedule · outpatient | $987 | $987 | — | — | — | $987 – $987 |
| 9 | Molina medicaid|< 21 fee schedule · inpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Molina medicaid|> 21 fee schedule · inpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 11 | Anthem medicaid|all plans fee schedule · inpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 12 | Anthem commercial|mcs fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | Cigna commercial|all other plans fee schedule · inpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 14 | Cigna commercial|ppo fee schedule · inpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 15 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 16 | Aetna commercial|all other plans fee schedule · inpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 17 | Aetna commercial|hmo fee schedule · inpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 18 | Aetna commercial|ppo fee schedule · inpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 19 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 20 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 21 | First Health commercial|all plans fee schedule · inpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 22 | First Health commercial|all plans fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 23 | Kaiser commercial|all plans fee schedule · inpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 24 | Kaiser commercial|all plans fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 25 | Blue Cross Blue Shield medicare|promise fee schedule · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
Last updated: Feb 28, 2026
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