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
Restorigin 1 sq cm
Hamilton, OH
See all hospitals reporting HCPCS Q4191 →Price type
Fort Hamilton Hospital’s median price of $295 is 20% below the median hospital's median price ($369), higher than 47% of the 917 hospitals reporting HCPCS Q4191. 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, 12 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 | Aetna medicare managed care plan fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 2 | Molina medicare managed care plan fee schedule · outpatient | $130 | $130 | — | — | — | $130 – $130 |
| 3 | Blue Cross Blue Shield anthem pathway hmox exchange fee schedule · outpatient | $186 | $186 | — | — | — | $186 – $186 |
| 4 | Caresource marketplace exchange fee schedule · outpatient | $191 | $191 | — | — | — | $191 – $191 |
| 5 | UnitedHealthcare exchange fee schedule · outpatient | $191 | $191 | — | — | — | $191 – $191 |
| 6 | Molina exchange fee schedule · outpatient | $256 | $256 | — | — | — | $256 – $256 |
| 7 | Blue Cross Blue Shield anthem - blue access/blue preferred hmo/ppo fee schedule · outpatient | $429 | $429 | — | — | — | $429 – $429 |
| 8 | Medical Mutual new buisness other commercial plan fee schedule · outpatient | $993 | $993 | — | — | — | $993 – $993 |
| 9 | UnitedHealthcare all commercial plans fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 10 | UnitedHealthcare employee fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 11 | Medical Mutual ppo fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 12 | Cigna all commercial plans fee schedule · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
Last updated: Apr 1, 2026
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