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
XWRAP 4X8 3529X-4588
Los Angeles, CA
See all hospitals reporting HCPCS Q4204 →Price type
Dignity Community Care’s median price of $12.2k is 3088% above the median hospital's median price ($381), higher than 99% of the 930 hospitals reporting HCPCS Q4204. 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, 28 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 | Blue Cross Blue Shield commercial|exchange case rate · outpatient | $855 | $855 | — | — | — | $855 – $855 |
| 2 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 3 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 4 | Molina medicaid|< 21 fee schedule · inpatient | $5.3k | $10.6k | $8.5k | 80% | — | $4.1k – $22.6k |
| 5 | Molina medicaid|< 21 fee schedule · outpatient | $5.3k | $10.6k | $8.5k | 80% | — | $4.1k – $22.6k |
| 6 | Molina medicaid|> 21 fee schedule · inpatient | $5.3k | $10.6k | $8.5k | 80% | — | $4.1k – $22.6k |
| 7 | Molina medicaid|> 21 fee schedule · outpatient | $5.3k | $10.6k | $8.5k | 80% | — | $4.1k – $22.6k |
| 8 | Anthem medicaid|all plans fee schedule · inpatient | $5.7k | $11.6k | $9.2k | 80% | — | $4.4k – $24.6k |
| 9 | Anthem medicaid|all plans fee schedule · outpatient | $5.7k | $11.6k | $9.2k | 80% | — | $4.4k – $24.6k |
| 10 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $6.0k | $12.0k | $9.6k | 80% | — | $4.6k – $25.5k |
| 11 | Anthem commercial|exchange fee schedule · outpatient | $8.0k | $16.2k | $12.9k | 80% | — | $6.2k – $34.4k |
| 12 | Cigna commercial|all other plans fee schedule · inpatient | $9.4k | $19.0k | $15.1k | 80% | — | $7.2k – $40.3k |
| 13 | Cigna commercial|ppo fee schedule · inpatient | $9.4k | $19.0k | $15.1k | 80% | — | $7.2k – $40.3k |
| 14 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $10.1k | $20.4k | $16.2k | 80% | — | $7.8k – $43.2k |
| 15 | Aetna commercial|all other plans fee schedule · inpatient | $12.2k | $24.5k | $19.5k | 80% | — | $9.4k – $52.1k |
| 16 | Aetna commercial|hmo fee schedule · inpatient | $12.2k | $24.5k | $19.5k | 80% | — | $9.4k – $52.1k |
| 17 | Aetna commercial|ppo fee schedule · inpatient | $12.2k | $24.5k | $19.5k | 80% | — | $9.4k – $52.1k |
| 18 | Anthem commercial|all other plans fee schedule · outpatient | $12.4k | $25.0k | $19.9k | 80% | — | $9.5k – $53.0k |
| 19 | Anthem commercial|mcs fee schedule · outpatient | $12.4k | $25.0k | $19.9k | 80% | — | $9.5k – $53.0k |
| 20 | First Health commercial|all plans fee schedule · inpatient | $15.8k | $31.9k | $25.4k | 80% | — | $12.2k – $67.8k |
| 21 | First Health commercial|all plans fee schedule · outpatient | $15.8k | $31.9k | $25.4k | 80% | — | $12.2k – $67.8k |
| 22 | Kaiser commercial|all plans fee schedule · inpatient | $16.1k | $32.4k | $25.8k | 80% | — | $12.4k – $68.8k |
| 23 | Kaiser commercial|all plans fee schedule · outpatient | $16.1k | $32.4k | $25.8k | 80% | — | $12.4k – $68.8k |
| 24 | Blue Cross Blue Shield medicare|promise fee schedule · outpatient | $17.2k | $34.7k | $27.6k | 80% | — | $13.2k – $73.7k |
| 25 | MultiPlan commercial|all plans fee schedule · inpatient | $18.1k | $36.6k | $29.1k | 80% | — | $13.9k – $77.6k |
Last updated: Feb 28, 2026
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