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
dextranomer-hyaluronate-sodchl 50-15 mg/mL gel for implant in syringe
Cheraw, SC
See all hospitals reporting HCPCS L8604 →Price type
McLeod Health’s median price of $3.7k is 2% above the median hospital's median price ($3.6k), higher than 50% of the 526 hospitals reporting HCPCS L8604. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 4 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 | Cigna commercial fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 2 | UnitedHealthcare commercial percent of total billed charges · bothfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 3 | Aetna commercial percent of total billed charges · bothfrom % of charges | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 4 | Tricare dha percent of total billed charges · bothfrom % of charges | $8.5k | $8.5k | — | — | — | $8.5k – $8.5k |
Last updated: Jul 20, 2026
See Prefilled Deflux injectable gel syringe, 1 mL pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.