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
DERMAL MATRIX ACELLULAR DERMASPAN 4 CM X 4 CM
Hackensack, NJ
See all hospitals reporting HCPCS Q4126 →Price type
Hmh Hospitals Corporation’s median price of $261 is 88% above the median hospital's median price ($139), higher than 77% of the 1,135 hospitals reporting HCPCS Q4126. 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, 14 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 | Clover medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $584 | $601 | $562 | 93% | — | $28 – $1.2k |
| 2 | Optum managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $713 | $735 | $687 | 93% | — | $34 – $1.5k |
| 3 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $960 | $988 | $924 | 93% | — | $46 – $2.0k |
| 4 | Cigna hmo facility · percent of total billed charges · bothfrom % of charges | $1.1k | $1.1k | $1.1k | 93% | — | $53 – $2.3k |
| 5 | Cigna ppo facility · percent of total billed charges · bothfrom % of charges | $1.1k | $1.1k | $1.1k | 93% | — | $53 – $2.3k |
| 6 | Aetna asa facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $1.3k | 93% | — | $66 – $2.9k |
| 7 | Aetna hmo facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $1.3k | 93% | — | $66 – $2.9k |
| 8 | Aetna ppo facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $1.3k | 93% | — | $66 – $2.9k |
| 9 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | $1.4k | 93% | — | $70 – $3.0k |
| 10 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | $1.4k | 93% | — | $70 – $3.0k |
| 11 | Aetna managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | $1.5k | 93% | — | $76 – $3.3k |
| 12 | UnitedHealthcare hmo facility · percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.9k | $1.8k | 93% | — | $88 – $3.8k |
| 13 | Cigna bh facility · percent of total billed charges · outpatientfrom % of charges | $2.6k | $2.7k | $2.5k | 93% | — | $124 – $5.4k |
| 14 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $2.8k | $2.8k | $2.7k | 93% | — | $132 – $5.7k |
Last updated: Dec 31, 2025
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