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
REVITA 4X4CM 1605X-2087
Phoenix, AZ
See all hospitals reporting HCPCS Q4180 →Price type
Dignity Health’s median price of $3.5k is 789% above the median hospital's median price ($391), higher than 96% of the 1,064 hospitals reporting HCPCS Q4180. 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 | $924 | $924 | $120 | 13% | — | $803 – $1.0k |
| 2 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $1.3k | $1.3k | $164 | 13% | — | $1.1k – $1.4k |
| 3 | Cigna commercial|exchange fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 4 | Cigna commercial|localplus surefit fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 5 | Cigna commercial|all other plans fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 6 | Aetna commercial|all plans fee schedule · outpatient | $2.6k | $2.6k | $336 | 13% | — | $2.2k – $2.9k |
| 7 | Optum commercial|optumhealth fee schedule · outpatient | $3.1k | $3.1k | $404 | 13% | — | $2.7k – $3.5k |
| 8 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 9 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 10 | Cigna commercial|lifesource fee schedule · outpatient | $3.6k | $3.6k | $473 | 13% | — | $3.2k – $4.1k |
| 11 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 12 | First Health commercial|all plans fee schedule · inpatient | $4.6k | $4.6k | $602 | 13% | — | $4.0k – $5.2k |
| 13 | First Health commercial|all plans fee schedule · outpatient | $4.6k | $4.6k | $602 | 13% | — | $4.0k – $5.2k |
| 14 | MultiPlan commercial|all plans fee schedule · inpatient | $5.2k | $5.2k | $680 | 13% | — | $4.5k – $5.9k |
| 15 | MultiPlan commercial|all plans fee schedule · outpatient | $5.2k | $5.2k | $680 | 13% | — | $4.5k – $5.9k |
| 16 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $6.2k | $6.2k | $420 | 7% | — | $5.7k – $6.6k |
Last updated: Feb 28, 2026
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