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 ULT TRILY MTRX/SQCM
Phoenix, AZ
See all hospitals reporting HCPCS Q4124 →Price type
Dignity Health’s median price of $456 is 324% above the median hospital's median price ($108), higher than 87% 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: 7 payers, 16 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 | $10 | $10 | — | — | — | $10 – $10 |
| 2 | Cigna commercial|exchange fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 3 | Cigna commercial|localplus surefit fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 4 | Cigna commercial|all other plans fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 5 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 6 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 7 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 8 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 9 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $170 | $170 | — | — | — | $170 – $170 |
| 10 | Aetna commercial|all plans fee schedule · outpatient | $349 | $349 | — | — | — | $349 – $349 |
| 11 | Optum commercial|optumhealth fee schedule · outpatient | $420 | $420 | — | — | — | $420 – $420 |
| 12 | Cigna commercial|lifesource fee schedule · outpatient | $492 | $492 | — | — | — | $492 – $492 |
| 13 | First Health commercial|all plans fee schedule · inpatient | $626 | $626 | — | — | — | $626 – $626 |
| 14 | First Health commercial|all plans fee schedule · outpatient | $626 | $626 | — | — | — | $626 – $626 |
| 15 | MultiPlan commercial|all plans fee schedule · inpatient | $706 | $706 | — | — | — | $706 – $706 |
| 16 | MultiPlan commercial|all plans fee schedule · outpatient | $706 | $706 | — | — | — | $706 – $706 |
Last updated: Feb 28, 2026
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