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
GRFTJKT 28SQCM 3529X-4588
Carmichael, CA
See all hospitals reporting HCPCS Q4107 →Price type
Dignity Health’s median price of $4.1k is 1780% above the median hospital's median price ($216), higher than 90% of the 1,584 hospitals reporting HCPCS Q4107. 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, 36 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 | $96 | $96 | — | — | — | $96 – $96 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $96 | $96 | — | — | — | $96 – $96 |
| 3 | Anthem commercial|connection epo fee schedule · outpatient | $144 | $144 | — | — | — | $144 – $144 |
| 4 | Anthem commercial|all other plans fee schedule · outpatient | $180 | $180 | — | — | — | $180 – $180 |
| 5 | Molina medicaid|all plans fee schedule · outpatient | $180 | $180 | — | — | — | $180 – $180 |
| 6 | Anthem medicaid|all plans fee schedule · outpatient | $182 | $182 | — | — | — | $182 – $182 |
| 7 | Cigna commercial|localplus fee schedule · outpatient | $200 | $200 | — | — | — | $200 – $200 |
| 8 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 9 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 10 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 11 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 12 | Anthem commercial|mcs fee schedule · outpatient | $251 | $251 | — | — | — | $251 – $251 |
| 13 | Cigna commercial|all other plans fee schedule · outpatient | $267 | $267 | — | — | — | $267 – $267 |
| 14 | Kaiser commercial|all plans fee schedule · inpatient | $2.8k | $3.0k | $1.3k | 44% | — | $1.4k – $5.3k |
| 15 | Kaiser medicaid|all plans fee schedule · inpatient | $2.8k | $3.0k | $1.3k | 44% | — | $1.4k – $5.3k |
| 16 | Kaiser medicare|all plans fee schedule · inpatient | $2.8k | $3.0k | $1.3k | 44% | — | $1.4k – $5.3k |
| 17 | Anthem medicaid|all plans fee schedule · inpatient | $2.9k | $3.2k | $1.4k | 44% | — | $1.5k – $5.5k |
| 18 | Molina medicaid|all plans fee schedule · inpatient | $3.1k | $3.4k | $1.5k | 44% | — | $1.6k – $6.0k |
| 19 | Cigna commercial|localplus fee schedule · inpatient | $4.8k | $5.3k | $2.3k | 44% | — | $2.5k – $9.2k |
| 20 | Kaiser medicaid|all plans fee schedule · outpatient | $4.9k | $5.4k | $2.4k | 44% | — | $2.5k – $9.4k |
| 21 | Cigna commercial|all other plans fee schedule · inpatient | $6.4k | $7.0k | $3.0k | 44% | — | $3.3k – $12.2k |
| 22 | Kaiser commercial|all plans fee schedule · outpatient | $6.5k | $7.1k | $3.1k | 44% | — | $3.3k – $12.4k |
| 23 | Blue Cross Blue Shield commercial|aco trio fee schedule · inpatient | $7.8k | $8.5k | $3.7k | 44% | — | $4.0k – $14.9k |
| 24 | First Health commercial|all plans fee schedule · inpatient | $9.0k | $9.8k | $4.3k | 44% | — | $4.6k – $17.2k |
| 25 | First Health commercial|all plans fee schedule · outpatient | $9.0k | $9.8k | $4.3k | 44% | — | $4.6k – $17.2k |
Last updated: Feb 28, 2026
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