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
Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)
Plano, TX
See all hospitals reporting HCPCS Q4302 →Price type
Medical City Plano’s median price of $210 is 29% below the median hospital's median price ($296), higher than 36% of the 873 hospitals reporting HCPCS Q4302. 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, 17 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 | Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 2 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 3 | Blue Cross Blue Shield bluepremier fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Blue Cross Blue Shield blueessentials fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 6 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 7 | Blue Cross Blue Shield ppo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 8 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
| 9 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
| 10 | UnitedHealthcare smallgroup fee schedule · outpatient | $210 | $210 | — | — | — | $210 – $210 |
| 11 | Humana tricare fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 12 | Cigna localplus fee schedule · outpatient | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 13 | Cigna newbusiness fee schedule · outpatient | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 14 | Cigna hmo fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 15 | Cigna networkbenefit fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 16 | Cigna openaccessplus fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 17 | Cigna allother fee schedule · outpatient | $10.9k | $10.9k | — | — | — | $10.9k – $10.9k |
Last updated: Mar 1, 2026
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