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
Kettering, OH
See all hospitals reporting HCPCS Q4191 →Price type
Kettering Medical Center ’s median price of $293 is 21% below the median hospital's median price ($373), higher than 46% of the 912 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 | $129 | $129 | — | — | — | $129 – $129 |
| 3 | Blue Cross Blue Shield anthem pathway hmox exchange fee schedule · outpatient | $183 | $183 | — | — | — | $183 – $183 |
| 4 | Caresource marketplace exchange fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 5 | UnitedHealthcare exchange fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 6 | Molina exchange fee schedule · outpatient | $255 | $255 | — | — | — | $255 – $255 |
| 7 | Blue Cross Blue Shield anthem - blue access/blue preferred hmo/ppo fee schedule · outpatient | $423 | $423 | — | — | — | $423 – $423 |
| 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 supermed 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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