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
DERMACL 4X4CM 949X-1234
Phoenix, AZ
See all hospitals reporting HCPCS Q4122 →Price type
Dignity Health’s median price of $754 is 305% above the median hospital's median price ($186), higher than 81% of the 1,355 hospitals reporting HCPCS Q4122. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 15 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|all plans fee schedule · outpatient | $113 | $113 | — | — | — | $113 – $113 |
| 2 | Cigna commercial|exchange fee schedule · outpatient | $128 | $128 | — | — | — | $128 – $128 |
| 3 | Cigna commercial|localplus surefit fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 4 | Cigna commercial|all other plans fee schedule · outpatient | $180 | $180 | — | — | — | $180 – $180 |
| 5 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $532 | $532 | $307 | 58% | — | $225 – $838 |
| 6 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $554 | $554 | — | — | — | $554 – $554 |
| 7 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $554 | $554 | — | — | — | $554 – $554 |
| 8 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $738 | $738 | — | — | — | $738 – $738 |
| 9 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Optum commercial|optumhealth fee schedule · outpatient | $1.3k | $1.3k | $759 | 58% | — | $556 – $2.1k |
| 11 | Cigna commercial|lifesource fee schedule · outpatient | $1.5k | $1.5k | $888 | 58% | — | $651 – $2.4k |
| 12 | First Health commercial|all plans fee schedule · inpatient | $2.0k | $2.0k | $1.1k | 58% | — | $829 – $3.1k |
| 13 | First Health commercial|all plans fee schedule · outpatient | $2.0k | $2.0k | $1.1k | 58% | — | $829 – $3.1k |
| 14 | MultiPlan commercial|all plans fee schedule · inpatient | $2.2k | $2.2k | $1.3k | 58% | — | $935 – $3.5k |
| 15 | MultiPlan commercial|all plans fee schedule · outpatient | $2.2k | $2.2k | $1.3k | 58% | — | $935 – $3.5k |
Last updated: Feb 28, 2026
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