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 TRI 3X3.5CM150X-195
Sacramento, CA
See all hospitals reporting HCPCS Q4124 →Price type
Dignity Community Care’s median price of $21 is 80% below the median hospital's median price ($108), higher than 30% of the 1,428 hospitals reporting HCPCS Q4124. 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, 37 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 medicaid|< 21 fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Anthem commercial|connection epo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Anthem commercial|all other plans fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 5 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 6 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 7 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 8 | Molina medicaid|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 9 | Anthem medicaid|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 10 | Anthem commercial|mcs fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 11 | Cigna commercial|localplus fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 12 | Cigna commercial|all other plans fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 13 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $44 | $37 | $10 | 27% | — | $23 – $44 |
| 14 | Kaiser commercial|all plans fee schedule · inpatient | $224 | $242 | $201 | 83% | — | $5 – $496 |
| 15 | Kaiser medicaid|all plans fee schedule · inpatient | $224 | $242 | $201 | 83% | — | $5 – $496 |
| 16 | Kaiser medicare|all plans fee schedule · inpatient | $224 | $242 | $201 | 83% | — | $5 – $496 |
| 17 | Anthem medicaid|all plans fee schedule · inpatient | $234 | $252 | $209 | 83% | — | $6 – $517 |
| 18 | Molina medicaid|all plans fee schedule · inpatient | $254 | $273 | $227 | 83% | — | $6 – $560 |
| 19 | Cigna commercial|localplus fee schedule · inpatient | $390 | $420 | $349 | 83% | — | $9 – $862 |
| 20 | Kaiser medicaid|all plans fee schedule · outpatient | $400 | $431 | $358 | 83% | — | $9 – $884 |
| 21 | Cigna commercial|all other plans fee schedule · inpatient | $517 | $557 | $462 | 83% | — | $12 – $1.1k |
| 22 | Blue Cross Blue Shield commercial|aco trio fee schedule · inpatient | $585 | $631 | $523 | 83% | — | $14 – $1.3k |
| 23 | Anthem commercial|brms fee schedule · inpatient | $702 | $757 | $628 | 83% | — | $17 – $1.6k |
| 24 | Anthem commercial|brms fee schedule · outpatient | $702 | $757 | $628 | 83% | — | $17 – $1.6k |
| 25 | First Health commercial|all plans fee schedule · inpatient | $731 | $788 | $654 | 83% | — | $17 – $1.6k |
Last updated: Feb 28, 2026
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